
Class 



Mji 



«nd. .Mas 



ropYRiorr deposit 



THE 



NEW MEDICAL WORLD. 



A BOOK FOR REFERENGE AND CONSULTATION 



CONTAINING A 



THOROUGH DESCRIPTION OF DISEASE 



WITH THE LATEST AND BEST METHODS FOR ITS 

TREATMENT. 

ALSO 

POPULAR AND PRACTICAL DISCUSSIONS 



ON MEDICAL PROGRESS, HEALTH, MARRIAGE, 

MATERNITY, THE CARE OF CHILDREN, 

NURSING OF THE SICK AND 

MANY OTHER TOPICS OF 



WORLD-WIDE INTEREST. 



BY E. EDGAR MARYOTT, A.M., M.D. 



ILLUSTRATED. 



1897. 

The Hampden Publishing Co., Publishers, 
springfield, mass. 



?. 



^ 



Copyright, 1897 

BY HAMPDEN PUBLISHING CO., 

Springfield, Mass. 



" I have often said, what profession is there equal in true nobleness to medicine r 
He that can abolish pain and relieve his fellow mortal from sickness, he is indisputably 
the usefulest of men. Him savage and civilized will honor ; he is in the right, be in the- 
wrong who may." — Carlyle. 



CL\KK W. I.RYAN CO.. 

fKIMKHS AM) 1IINDEK8, 

BprtnftfieM, v 



AUTHOR'S PREFACE, 



THE title of this book, "The New Medical World," does 
not imply that a new system of medicine has been discovered; 
for this is no announcement of novel, or untried methods. 

There have been, however, so many recent advances in the practice 
of medicine and surgery, as the result of bacteriological study, that 
it seems fitting to recognize them in a popular work. It is therefore 
believed that a book which delineates the latest and best in Medicine 
will be appreciated and accorded a favorable reception. 

It has been the author's purpose to prepare a practical, modern and 
reliable work upon domestic medicine, which shall comprise the 
best known in medical literature suitable for the convenient use of 
the masses as a book of reference in health or sickness. 

It contains a large amount of practical information, and will prove 
an earnest instructor and counselor to every one who possesses a 
thirst for medical knowledge ; and when an emergency occurs it will 
enable one to act promptly, and to determine what course to pursue 
for the best interest of all. 

It is not the purpose of the book to so instruct the masses that 
they will become experts in the healing art, for that would be impos- 
sible. It aims rather to be helpful by bringing into prominence 
many interesting and important facts ; and hence it is essentially a 
book of instruction and reference. 

It tells what to avoid and how to live in order to maintain good 
health. Directions for nursing the sick, advanced ideas upon the 
care and education of children are included ; so that in this regard it 
is believed that it will be especially helpful to a large number of 
persons. The methods of treatment proposed are, for the most part, 
simple and efficient, such as can be understood by a mother, a nurse 
or any persons of ordinary intelligence. The prescriptions have been 



iv. PREFACE. 

prepared with care, and are the result of experience and successful 
practice, and are of unusual value. 

The treatment of all the more dangerous diseases could have been 
withheld, but this would have greatly marred the completeness and 
worth of the work. It is hardly to be expected that any person, 
without a suitable degree of medical knowledge, will desire to treat 
any except the more simple forms of disease, and yet it has seemed 
necessary to enter somewhat into details for the sake of information. 

The work includes a brief discussion of many interesting and 
practical topics, closely allied to medicine, as healthy homes, food, 
clothing, climate, exercise, drainage, the water supply, the preven- 
tion of disease, necessary disinfection after contagious diseases, 
surgical hints upon fractures, hemorrhage and other emergencies. 
It attempts in this way to show the bearing of many topics not 
strictly medical to the conditions of health and disease, in order that 
correct living may be more easily attained. 

Attention is also called to that part of the work which gives advice 
to those who co)demi)late marriage. The Chapter upon Marriage 
and Maternity contains many useful suggestions and directions. 

It is designed to be a safe book for perusal or study, by young 
or old and with this end in view it has been examined and received 
the sanction of eminent clergymen and physicians. In so far as it 
has been deemed necessary to consider or discuss delicate topics, 
it conforms to good taste and will give satisfaction to the culti- 
vated and those morally sensitive. 

Technical language has been avoided so far as possible, with the 
belief that a medical work requiring constant reference to a dic- 
tionary would be of doubtful utility. The classification adopted is 
natural rather than scientific as a simple arrangement is more in 
accord with the general plan and purpose of the work. 

The author has performed his task with scrupulous care, and 

believes that he has prepared a Medical book adapted to the every 

day need and use of the people. 

E. E. MAKYOTT. 
Springfield, M vss., July 1, L897. 



CONTENTS 



CHAPTER I. 

Page 

Introductory Articles, .... 1 

I. Medical Progress and X Kays, - - 1—1 

II. Medical Study Fascinating, ... 6 

III. Medicine a Popular Science, - 7 

IV. Medical Common Sense, ... 8 
V. General Causes of Disease, - 9 

VI. Special Causes of Disease, ... 11 

VII. Bacteria, or Germs in Disease, - - 12 

CHAPTER II. 

Sanitary Subjects, - - - - - 17 

I. The Choice of a Home, - - - 17 

II. The House Furnishings, - 20 

III. Drainage and Sewerage, - 21 

IV. The Air and Ventilation, - - - 24-26 
V. The Water Supply, - 29 

VI. Food, 32 

VII. Clothing, - - - - 36 

VIII. Climate, - - - - - 40 

IX. Exercise, ----- 43 

X. Longevity, - - - - - 47 

CHAPTER III. 

General Topics of Interest in Medicine, - 52 

I. Home Prescribing, - 52 

II. Strange Delusions, - 53 

III. Patent Medicines, - 55 

IV. Medicines, - - - - - 57 
V. Doses, ------ 75 

VI. Household Remedies, - 80 

CHAPTER IV. 

Poisons and their Antidotes, - 88 

I. Poisons in General, - 88 

II. The Mineral Acids, - 91 



VI, I oXTENTS, 

Pagk 

III. Oxalic Acid, ----- 92 

IV. Carbolic Acid and Creosote, - 92 
V. Acetic Acid, ----- 93 

VI. Ammonia, ----- 93 

VII. Prosaic or Hydrocyanic Acid, - 93 

VIII. Arsenic and its Preparations, - - - 94 

IX. Copper, Mercury and Zinc Compounds, - 95 

X. Tartar Emetic, : 95 

XI. Lead Compounds, ... - 96 

XII. Nitrate of Silver, - 96 

XIII. Phosphorus, ----- 96 

XIV. Opium and Morphine, - 97 
XV. Chloral Hydrate, ... - 97 

XVI. Strychnia, ----- 98 

XVII. Aconite and Vegetable Poisons, - 98 

XVIII. Poison Iw, ----- 98 

XIX. Poison Gases, - 100 

CHAPTER V. 

The Use <>k Alcohol axd other Dangerous or 

Narcotic Drugs, ----- 102 

I. Alcohol, its Use and Abuse, - - - 10*2 

II. Chronic Alcoholism, - 104 

III. The Morphine, Cocaine and Chloral Habits, - 107 

IV. The Effects of Tobacco, 109 

CHAPTER VI. 

Ac< iii\ rs, - - - - - - 111 

I. Drowning, - - - - - m 

II. Painting, - - - - - 112 

III. Burns and Scalds, .... 113 

IV. Lightning Stroke, .... iig 
V. Sprains and Bruises, - 11(5 

VI. Frost Bite, ... . . . 119 

VII. Bites of Serpents, - - - - 120 

VIII. Stings of In-ects, - - - - 121 

IX. Poisoned Wounds, .... 122 

X. Hemorrhage from Wounds and the Treatment 

of Wounds in General, - - - 1*24 

XI. [noised Wounds, - 126 

XI !. Scalp Wounds. .... 127 

CHAPTER VII. 

Gknkrai - trrs Prelimixabi ro the Stud? 0* 

Disease, - - - . . [28 

I. [leal tli iii.l I useaso, - - - [28 



CONTENTS. Vll. 

Pagk. 

II. The Two Great Types of Disease, - - 131 

III. Temperature in Disease, ... 133 

IV. Kissing in its Relation to Disease, - - 135 
V. Bathing in its Relation to Disease, - - 136 

VI. Symptoms of Disease, How to Read and In- 
terpret Them, - - - - 137 

CHAPTER VIII. 

Anatomy and Physiology, Including the Bones, 

Joints and Muscles, - 149 

I. Anatomy and Physiology, - - - 149 

II. The Relation of Physiology to Anatomy, - 151 

III. The Anatomy of the Bones, - - - 153 

IV. The Bones of the Skull, - - 153 
V. The Bones of the Face, - - - 155 

VI. The Spinal Column, - - - - 157 

VII. Injuries of the Spine, - 159 
VIII. The Bones of the Upper Extremities, Chest 

and Pelvis, - - - - - 160 

IX. The Bones of the Lower Extremities, - 168 

X. The Joints, - - - - 166 

XL The Muscles, ----- 166 

XII. Nature's Effort to Prevent Injury, - - 168 

XIII. The Fracture of Bones, - - 171 

XIV. Dislocations. - - - - - 176 

CHAPTER IX. 

The Blood and its Diseases, - 179 

I. Anaemia, - 180 

II. Chlorosis, ------- 182 

III. Leukaemia, - - - - - 183 

IV. Septicaemia — Pyaemia. Blood Poisoning, - 183 

CHAPTER X. 

The Lymphatic System and Glandular Diseases, - 187 

I. The Lymphatic System, - - - 187 

II. Scrofula, - - - - - 189 

III. The Pancreas, 191 

IV. Diseases of the Pancreas, - - - 19*2 

CHAPTER XL 

The Skin — its Anatomy, Functions and Diseases, 194 

I. The Skin, ' - - - - - 194 

II. Management of the Skin, - 200 



Vlll. 



CONTENTS. 



III. 

IV. 

V. 

VI. 



VII. 
VIII. 

IX. 

X. 

XI. 

XII. 

XIII. 

XIV. 

XV. 

XVT. 

XVII. 

XVIII. 

XIX. 

XX. 

XXI. 

XXII. 

XXIII. 

XXIV. 



Cosmetics, 

General Observations on Diseases of the Skin, 

Disorders of the Sweat Glands, 

Disorders of the Sebaceous Glands. 1. Sebor- 
rhea or Dandruff. 2. Wens or Tumors 
of the Scalp. 3. Baldness or Alopecia. 

Acne and Comedo, T 

Milium, - 

Prurigo, Itching or Pruritus - 

Shingles or Herpes Zoster, 

Eczema, Tetter, Milk Crust or Salt Rheum, - 

Urticaria, Hives or Nettle Rash, 

Psoriasis, - 

Leprosy, - 

Lice or Pediculosis, - 

Itch or Scabies, - 

Ringworm or Tinea, - 

Favus, - 

Freckles or Lentigo, - 

Moles, - 

Warts, - 

Corns or Clavus, - 

Bunions, - - - - 

Scurvv. - 



Page. 

202 
202 
205 



207 
212 
215 
215 
216 
218 
220 
221 
222 
223 
224 
226 
227 
227 
228 
229 
229 
231 
231 



CHAPTER XII. 



The Brain, Cranial Nerves, Spinal Cord, Nerves, 

Sympathetic Nerves and Their Diseases, - 233 

I. The Brain and Cranial Nerves, 
II. The Nerves and Spinal Cord, 

III. Hydrocephalus or Dropsy of the Brain, 

IV. Meningitis or Inflammation of the Brain, 
V. Neuralgia, - 

VI. Headache, - - - 

VII. Vertigo or Dizziness, - 

VIII. Insomnia, - 

IX. Insanitv, - 

X. Apoplexy. 

XI. Various Other Diseases of the Brain. 1. 
seess of the Brain. 2. Tumors of 
Brain. .'>. Aphasia. 4. Amnesia. 
Numbness. <*>. Hemiplegia. 7. Paraplegia. 
s Locomotor Ataxia. 5*. Facial Paralysis. 
K>. Congenita] Defects. - - - 258 



- 


233 


- 


238 


- 


240 


- 


241 


. 


242 


- 


24o 


. 


247 


• 


24S 


■ 


249 


- 


251 


Vb- 




the 




5. 





CONTENTS. IX. 

CHAPTER XIII. 

Page. 

The Eye, its Appendages and Diseases, - - 256 

I. Description of the Eye. 1. The Orbits. 2. 
The Optic Nerves. 3. The Sclerotic. 4. 
The Choroid. 5. The Iris. 6. The Cil- 
iary Muscle or Ligament. 7. The Ciliary 
Processes. 8. The Retina. 9. The Interior 
of the Eye. 10. The Appendages of the 
Eye. ----- 257-262 

II. Examination of the Eyes. 1. Errors of Re- 
fraction. 2. Myopia or Near Sight. 3. 
Hypermetropia or Far Sight. 4. Pres- 
byopia or Old Sight. 5. Astigmatism, - 262-264 

III. The Use of Glasses, and Directions for Testing 

the Eyesight, - 264-268 

IV. Care of the Eyes, - - - 268-270 
V. Diseases of the Eye. I. Ulcers. 2. Paralysis. 

3. Twitching of the Lids. 4. Inflamma- 
tion of the Eye. 5. Stye. 6. Blepharitis. 
7. Wounds of the Eyelids. 8. Conjunct- 
ivitis or Ophthalmia. 9. Purulent Oph- 
thalmia. 10. Granular Ophthalmia or Gran- 
ular Lids, - 270-273 
VI. Foreign Bodies in the Eye, - - - 273 
VII. Inflammations of the Cornea (Corneitis). 1. 
Ulcers of the Cornea. 2. Corneal Opacities. 
3. Staphyloma, - 273 
VIII. Inflammation of the Iris or Iritis, - - 275 
IX. Inflammation of the Choroid, - 276 
X. Sympathetic Inflammation, - 276 
XL Glaucoma, - 276 
XII. Inflammation of the Retina, - 277 
XIII. Inflammation of the Optic Nerve, - - 277 
• XIV. Cataract, ----- 277 
XV. Cross Eye, Squint or Strabismus, - - 279 
XVI. Various Other Affections. 1. Growths. 2. In- 
flammation of the Tear Duct. 3. Ab- 
scesses of the Lachrymal Sac - - 279-280 

CHAPTER XIV. 

The Ear and its Diseases, - 281 

I. Description of the Ear. 1. The External Ear. 
2. The Auditory Canal. 3. The Middle 
Ear or Tympanum. 4. The Eustachian 
Tube arid the Ossicles. 5. The Internal 
Ear or Labyrinth, - - - 281-282 



A. CONTENTS. 



Page. 



II. Diseases of the Ear. 1. Deafness. 2. Im- 
pacted Wax or Cerumen. 3. Foreign 
Bodies in the Ear. 4. Inflammation of the 
Ear. 5. Polypi. 282 

III. Diseases of the Middle Ear. 1. Rapture of 

the Drum. 2. Acute and Chronic Catarrh 
of the Middle Ear or Otitis Media. 3. 
Inflation of the Middle Ear. 4-. Con- 
genital Defects of the Ear, - - 285 

IV. Mastoid Disease. .... 287 



CHAPTER XV. 

The Nose and its Diseases, - 289 

I. Description of the Xose, - 289 

II. Acute Coryza or Cold in the Head, - - 290 

III. Ulcers in the Nasal Cavity. - - - 291 

IV. Other Affections. 1. Warts. 2. Polypi. 

3. Tumors, etc., 292 

V. Hemorrhage from the Nose, - 292 

VI. Chronic Nasal Catarrh, - - - 293 

VII. Hay Fever, Rose Cold or Summer Catarrh, - 295 



CHAPTER XVI. 

The Mouth and its Appendages, ... 298 

I. Description of the Mouth and its Appendages. 
1. The Mouth. *2. The Upper and Lower 
Jaw. 3. The Mucous Membrane. 4. The 
Lips. 5. The Cheeks. 6. The Glands. 
7. The Toncrue. 8. The Gums. 9. The 
Antrum. 10. The Palate. 11. The 

Teeth, 298-301 

II. Diseases of the Mouth, Tongue and Vicinity. 
1. Alveolar Abscess or Gum Boil. 2. 
Catarrhal Stomatitis. 3. Canker or Aph- 
thous Sore Mouth. 4. Gangrenous Stom- 
atitis or Can crum Oris. 5. Toxic Stoma- 
titis. (I. Other Minor or Rare Affections, 
a. Calculus of the Ducts, b. Salivary 
Fistula. c. Growths, d. Hare Lip. e, 
Hypertrophy of the laps. 7. Diseases of 
the Tongue, a. Tongue Tie. b. Enlarge- 
ment of the Tongue or Hypertrophy, c. 
Inflammation of the Tongue or Glossitis, 801-305 



CONTEXTS. XI. 

CHAPTER XVII. 

Page 

The Throat, Larynx and their Diseases, - - 306 

I. Description of the Throat and Larynx. 1. 

The Throat. 2. The Larynx, - - 306 

II. Affections of the Throat. 1. Getting Choked. 





2. Taking Cold, - 


306 


III. 


Acute Sore Throat or Laryngitis, 


307 


IV. 


Chronic Sore Throat or Clergyman's Sore 






Throat, - - - 


308 


V. 


Loss of Voice or Aphonia, - 


309 


VI. 


Quinsy Sore Throat or Tonsilitis, 
CHAPTER XVIII. 


309 


The Trachea or Windpipe, Lungs and their Dis- 




eases 


> 


312 


I. 


The Trachea, ----- 


312 


II. 


The Lungs, ----- 


313 


III. 


Asthma, - 


314 


IV. 


Bronchitis, ----- 


315 


V. 


Capillary Bronchitis, - 


317 


VI. 


Pleurisy, - 


318 


VII. 


Pneumonia, - 


320 


VIII. 


Consumption, - 


322 


IX. 


The Prevention of Consumption, 


325 



CHAPTER XIX. 

The (Esophagus and Stomach, - 328 

I. The (Esophagus and its Affections, - - 328 

II. Description of the Stomach and Digestion, - 329 

III. Dyspepsia or Indigestion, - 331 

IV. Gastritis, Gastric Fever or Inflammation of the 

Stomach, ----- 334 

V. Gastric Ulcer or L^lcer of the Stomach, - 335 

VI. Nausea and Vomiting, - 336 

VII. Gastralgia, Stomach Ache or Xeuralgia of the 

Stomach, - - - - 337 

VIII. Cancer of the Stomach, - - - 338 

IX. Loss of Appetite, - 33* 

X. Unnatural Appetite, - 339 

XL Hiccough. ----- 340 

CHAPTER XX. 

The Liver, Spleen and Gall Bladder, - - 341 

I. Description of the Liver and its Functions, - 341 

II. The Gall Bladder, - 344 



Xll. 



CONTEXTS. 



III. Diseases ot* the Liver in General, 

IV. Congestion of the Liver, - 
V Jaundice or Icterus, - 

VI. Cirrhosis or Hardening of the Liver, - 

.VII. Gall Stones and Bilious Colic, 

VIII. Other Affections of the Liver. 1. Abscess of 
the Liver. 2. Cancer of the Liver. 3. 
Fatty Degeneration of the Liver. 4. Amy- 
loid Degeneration of the Liver. 5. Acute 
Yellow Atrophy. 6. Hydatid Disease of 
the Liver. - 

IX. The Spleen and its Diseases. 1. Inflamma- 
tion. 2. Enlargement. ... 



Page. 

344 
345 
346 
348 
349 



350 
352 



CHAPTER XXI. 

The Heart, Circulation, Pericardium, Blood Ves- 
sels AND THEIR DISEASES, - - 354 

I. Description of the Heart and its Valves, - 354 

II. The Circulation, - 357 

III. Overwork of the Heart or Heart Strain, - 359 

IV. The Pericardium or Heart Sac, - - 359 
V. Inflammation of the Heart Sac or Pericarditis, 360 

VI. Valvular Disease of the Heart or Endocarditis, 361 

VII. Angina Pectoris or Neuralgia of the Heart, - 363 

VIII. Palpitation. ----- 364 
IX. Various other Diseases of the Heart. 1. 
Hypertrophy or Enlargement of the Heart. 

2. Fatty Degeneration, - - - 365 
X. The Blood Vessels and their Diseases. 1. 

Aneurism. 2. Varicose Veins, - - 366-367 



CHAPTER XXII. 

The Intestines, Rectum and their Diseases, - 368 

I. The Small Intestine, - :;<is 

II. The Large Intestine, - -570 

III. Diseases ot* the Rectum. 1. Congenital De- 

formity. 2. Injuries of the Rectum. 3. 
Fissure and Ulcer. 4. Recta] Abscesses 
and Fistula. 5. Itching about the Anus 
orPruritus. 6. Piles or Hemorrhoids. 7. 
Prolapse of the Rectum. 8. Polypi, - 371-376 

IV. Other Rectal Affections. 1. Stricture. '2. 

Cancer. - - - 375 

V Rectal Alimentation, 376 



CONTENTS. Xlll. 

Page 

VI. Intestinal Catarrh, - 376 

VII. Dysentery, - 378 
VIII. Cholera Morbus, ... 379 

IX. Cholera, Asiatic, 381 
X. Inflammation of the Bowels, Obstruction and 

Appendicitis, ...•-.. 383-385 

XI. Hernia, Breech or Rupture, - - - 385 

XII. Peritonitis, ----- 387 

XIII. Colic, - 388 

XIV. Constipation, - - - - - * 389 
XV. Worms, - 391-395 

CHAPTER XXIII. 

The Kidneys and their Diseases, ... 396 

I. Description of the Kidneys, - - - 396 

II. The Secretions of the Kidneys, - - 398 

III. Diseases of the Kidneys. 1. Gravel. 2. 

Renal Colic. 3. Pyelitis. 4. Abscess. 

5. Cancer. 6. Hydatid Disease, - - 399 

IV. Brigkt's Disease. - 400 
V. Diabetes, -' - - - - 403 

VI. The Supra-renal Capsules, - - - 405 

VII. How to Preserve the Health of the Kidneys, - 405 

CHAPTER XXIV. 

The Bladder and the Urinary Appendages, - 407 

I. Description of the Bladder and Neighboring 
Tissues. 1. The Ureters. 2. The Urethra. 
3. The Prostate Gland. 4. Cowper's 
Glands, ----- 407 
II. Acute and Chronic Cystitis or Catarrhal Inflam- 
mation of the Bladder, ... 408 

III. Retention of Urine, - - - - 410 

IV. Suppression of the Urine, - - - 411 
V. Enuresis or Incontinence of Urine, - - 412 

VI. Stone in the Bladder or Vesical Calculus, - 413 

VII. Enlarged Prostate, - 414 

VIII. Other Obscure Affections, 416 

CHAPTER XXV. 

The Male Genital , Organs and Venereal Dis- 
eases, - 417 
I. Description of the Male Genital Organs, - 417 



XIV. 



CONTENTS. 



Pagb. 



II. Affections of the Male Genital Organs. 1. 
Phimosis. 2. Paraphimosis. 3. Congen- 
ital Malformation. 4. Warts. 5. Cancer 
of the Penis. <i. The Testicles. 7. Vari- 
cocele. 8. Hydrocele. 9. Hematocele. 
10. Orchitis. 11. Other Minor Affections, 

III. Chancre and Chancroid or Venereal Diseases, 

IV. Acquired Syphilis, - 
\ . Hereditary Syphilis, - 

VI. Gonorrhoea, Urethritis or Clap and its Com- 
plications. 1. Orchitis. 2. Bubo. 3. 



Chordee. 4. Gleet. 5 
orrhceal Rheumatism. 
Ophthalmia. 



Stricture. 6. Gon- 
7. Purulent 



418-421 
421 
422 
424 



425-429 



CHAPTER XXVI. 

The Female Genital Organs, ... 430 

I. Description of the Female Genital Organs. 
1. The Female Pelvis. 2. The Ovaries 
and their Functions. 3. The Fallopian 
Tubes. 4. The Uterus or Womb. - 430 

II. Menstruation and its Disorders. 1. Menstrua- 
tion. 2. * Delayed Menstruation. 3. 
Profuse Menstruation. 4. Cessation of 
Menstruation. 5. Care of Menstruation, 433-435 
III. Affections of the Female Genital Organs. 1. 
Pruritus or Troublesome Itching. 2. Leu- 
corrhoea, Whites or Female Weakness. 
3. Gonorrhoea in the Female. - - 436-438 



CHAPTER XXVII. 



Children's Diseases, - 440 

I. Chicken Pox or Varicella, - - - 440 

II. Croup, True or Membranous, - 441 

III. Croup, False or Laryngismus, - - 443 

IV. Cholera Infantum or Summer Complaint, - 444 
V Diphtheria, - 148 

VI. Measles or Rubeola, - 4f>i 

VII. Measles, German or Roseola, - 458 

VIII. Mumps or Parotiditis, - - - l;">4 

IX. Scarlet Fever or Scarlatina, - - - !.">•'> 

\. Whooping Cough <>r Pertussis, - - 459 

XI. Disinfection During and after Diphtheria and 

Scarlet Fever, - 4<>l 



CONTENTS. 

CHAPTER XXVIII. 

Fevers, ------ 

I. Bilious or Remittent Fever, 

II. Malarial or Intermittent Fever, 

III. Catarrhal Fever, Influenza or La Grippe, 

IV. Neuralgic Fever or Dengue, - 
V. Typhoid Fever, 

VI. Typhus Fever, 
VII. Yellow Fever, 
VIII. Puerperal Fever, 



xv. 



Pagk 

464 

464 
465 

468 
470 
471 
474 
476 
477 



CHAPTER XXIX. 



Nervous Diseases, 



I. 


Epilepsy. 


IT. 


Hysteria, 


III. 


Catalepsy, 


IV. 


Ecstacy, 


V. 


Chorea or St. Vitus Dance, 


VI. 


Convulsions, Fits or Spasms, 



479 

479 

480 
482 
483 
484 

486 



CHAPTER XXX. 

General or Unclassified Diseases, - 
I. Rickets or Rachitis, - 

II. Erysipelas, - 

III. Rheumatism, - 

IV. Gout, 

V. Obesity, - 

VI. Small Pox or Variola, - 

VII. Varioloid, - 

VIII. The Prevention of Small Pox or Vaccination, 



488 
490 
491 
494 
496 
497 
499 
500 



CHAPTER XXXI. 

Various Inflammatory Affections, - 

I. Inflammations, - 

II. Abscesses, - 

III. Felon or Whitlow, 

IV. Onychia or Suppuration of the Matrix, 
V. Ingrowing Nail or Onyxis, 

VI. Chilblains, * - 
VII. Boils and Furuncles, -• 
VIII. Carbuncles, - 



502 
502 
504 

505 
506 
507 
508. 
509 
511 



Xvi. CONTENTS. 

Page. 

IX. Malignant Pustule or Anthrax, - - 512 

X. Glanders, _ - - - - 513 

XI. Hydrophobia or Rabies, - - - 514 

XII. Tumors. 516 



CHAPTER XXXII. 



519 
519 
523 
525 
526 
529 
530 



Marriage and Maternity, 

I. Marriage, - - 

II. Reproduction, 

III. Symptoms of Pregnancy, 

IV. Diseases of Pregnancy, - 
V. Advice to the Pregnant, 

VI. Miscarriage, 

VII. Labor, Stages and Management, 531 

fill. Management of Infants, ... 530 

IX. Care and Education of Children, - - 542 

CHAPTER XXXIII. 

Nursing. Diet for the Sick and how to Prepare it, 546 

I. Nursing, - 546 

II. Diet for the Sick and its Preparation, - 549 



Gall-bladder 



Bight supra-renal 
capsule 



Descending 
duodenum 



Mesentery 



Ileum 
Ccecum 




Greater curvature 
of stomach 



Left kidney 

Trans, mesocolon 
Transverse colon 
Jejunum 



Sigmoid flexure 



%-UracJius 

1 



Relations of internal organs. Anterior view 



Left lobe of liver- 5 

Lobus Spigelii— 



Capsule of left's 
kidney 



Splenic vein - 



Inferior mesenteric 
vein 



Sigmoid. flexure 



Yas deferens 
Seminal vesicle— 4 




Vena cava inferior 



Non peritoneal 
surface 

Bight lobe of liver 

Impressio renal 
Gallbladder 

Impressio colic 

Capsule of right 
kidney 

Vena porta 

Common bile-duct 
Sup. mesen. vessels 

Mesocolon 



Back of 
peritoneum 



— Caecum 



Bladder 

Head of femur 
Brostate Glands 



Relations of internal organs. Posterior view 



CHAPTER I. 
INTRODUCTORY ARTICLES. 



I. Medical Progress. X Rats. — II. Medical Study Fasci- 
nating. — III. Medicine a Popular Science. — IV. Medi- 
cal Common Sense. — V. General Causes oe Disease. — 
VI. Special Causes of Disease. — VII. Bacteria, or 
Germs in Disease. 

I.— MEDICAL PROGRESS. 

MEDICINES must have been used at quite an early period in 
human history, the conditions of life being such that disease 
is inevitable. Only in jest can one habitually cast out the doctor 
and "throw physic to the dogs." 

To trace the history of medicine for a thousand, or even a hundred 
years, however interesting the process, becomes too tedious. In the 
past, many strange agents have been employed medicinally, which 
seem to us ridiculous, as for instance the hag-stone, which was sup- 
posed to keep the troublesome witches from sitting upon the sleeper's 
stomach, and thus prevent the nightmare 

The history of medicine has been associated to no little extent, 
with charlatans and pretenders; notwithstanding, we flatter our- 
selves that medical science has been making remarkable progress 
during the last half century. 

The medical men of to-day are trying faithfully to answer these 
questions : 

What ails the sick? What is the best method of treating dis- 
ease ? How can disease be prevented ? 

Notice what recent medical science has done to answer this 
question : What ails the sick ? 

It produces the microscope, to examine diseased tissues, and 
announce with certainty, the difference between a cancer and a 
harmless growth. 



THE NEW MEDICAL WOULD. 



It is able to disclose disease germs when they exist in the saliva, 
the sputa, the urine and other excretions, as well as in the food and 
water which we consume. 

It brings forward the fever thermometer, to record the accurate 
temperature <>f the body, and is capable of revealing whether pus is 
forming, or other danger signals. 

It lias invented the stethoscope, to exaggerate the abnormal sounds 
in the lungs and heart, so that diseased conditions are readily 
recognized. 

It provides many other delicate instruments to assist in the 
examination of the eye, the throat and other obscure organs. 

By the aid of these modern inventions, we are far better able 
to obtain a correct answer to the question: What ails the sick? 

Great progress has been made in modern times toward answering 
our second question : What is the best method of treating disease? 
Physiologists have made Important discoveries with living animals 
causing them to suffer for the good of man. There is no question 
but what much definite knowledge concerning the action of medi- 
cines upon the blood, the nerve centers, and other important tissues, has 
been obtained by these experiments upon the lower animals. In this, 
and in various other ways, medical science has been constantly ad- 
vancing and the sufferings of mankind correspondingly alleviated. 

The discovery of Ether and Chlo- 
roform for the relief of pain, 
marked an important advance in 
the science of medicine, while 
words almost fail to portray the 
benefits which attend their use in 
surgery. There are many surgical 
operations made successful by their 
use, which could not be attempted 
without them. 

Dr. William T. G. Morton, the 
Boston, Mass., dentist, who dis- 
covered anaesthesia, and opened up 
the way for painless operations 
in Surgery was born in L819, and 
died in l v «'»s. His claim was satisfactorily demonstrated on the 16th 
of October, L846, at the Massachusetts General Hospital. Before 
that time whenever misfortune rendered the surgeon's knife a 




UK. WILLIAM T. O. MORTON. 



THE NEW MEDICAL WORLD. 8 

necessity, the patient experienced an extreme sense of suffering and 
untold agony. Since then and for all future time the agony of the 
operating room has been and will forever be " steeped in the waters 
of forgetfulness." 

The injection of medicine under the skin, a comparatively recent 
method, antidotes and relieves the most agonizing pain. The hypo- 
dermic use of medicine, while it should be employed exclusively by 
physicians, has much in its favor. The medicine enters the cir- 
culation immediately, and is not altered and changed by the slow 
process of digestion, as it is when administered by the mouth, 
and it is able to relieve the severest pain in a very brief space 
of time, and thus beginning inflammations are conquered at the 
very threshold. There are many medicines which could be admin- 
istered in this way to great advantage, and are likely to be so 
employed more frequently in time to come. 

Electricity is an agent that has come somewhat to the front in 
medical practice, and is sometimes curative when other remedies 
have failed. It is used to improve the nutrition of wasting muscles, 
by stimulating and strengthening their nerve control ; hence it 
arrests atrophy or wasting, and restores power to limbs that are 
partially paralyzed. It is also used to remove superfluous hairs 
from fan faces, to destroy moles, birthmarks, and for various other 
purposes. 

Anyone can observe that great progress has been made in the 
management of acute diseases, in recent times ; instead of depletion, 
blisters, blood-letting, setons, issues, heroic doses of mercury and 
other powerful drugs, we present a method which we are certain 
yields better results. We sustain the strength of the patient and 
make use of good nursing and hygienic measures with increased 
success. 

The working of nature is at present more fully recognized in 
treating the sick ; it is found that with timely and simple assistance, 
she is often able to work the miracle of healing, with the aid of but 
very little medicine. 

Still more important than the questions already answered is this 
last one : How can disease be prevented ? 

Anxiety to answer this, has led to the vigorous study of hygiene 
and sanitary science. Such study is comparatively recent. Much 
attention is now being properly given to our water, ice, milk and 
other food supplies. The infectious germs, only recently recognized, 



4 i in, m;v. MEDICAL \voi:i.i>. 

producing typhoid and scarlet fever, diphtheria, consumption, and 
an exceedingly large list of other diseases, have been investigated 
irith untiring diligence, and with the avowed aim of preventing 

the spread of these undesirable, and often fatal infectious or con- 
tagious diseases. The habitat of these genus is sought <>nt to find 
where they originate and multiply, and what are the conditions 
favorable to their spread and multiplication. To this end, defective 
sewerage is inspected and remedied, well water suspected of con- 
tamination is analyzed, and a thousand matters are awakening gen- 
eral attention which relate to the prevention of disease, and hence 
the germs of disease are often destroyed and its spread prevented. 

We have learned that it is easier, safer, and less expensive to 
prevent disease, than to restore health after weeks of prostra- 
tion and suffering. 

There were never more agencies at work to prevent the spread of 
disease than at present, and as for medical men, they were never 
more intelligent, or better able to cope with it and baffle its ravages. 
In respect to these matters, the day which has dawned upon us 
knows no sunset. Eminent men may die, but progress in the 
healing art is destined to a perpetuity as lasting as the race. Facts 
are constantly accumulating, discoveries are being multiplied for 
curtailing human maladies, relieving human suffering, and check- 
ing the spread of infectious and contagious diseases. 

The present is often spoken of as the age of invention, the age 
of rapid transit, rapid transmission of speech, wonderful machinery 
and a thousand inventions, which, in the light of the past are marvel- 
ous ; but at the same time thoughtless persons are prone to intimate 
that medicine is now and lias forever been at a standstill, that so 
far as the medical profession is concerned, there has been no prog- 
ress. Such imputations are utterly without foundation. There is 
n<> body of men more keenly alive to every scientific improvement in 
the sphere of their labors than the large and educated body of 

physicians practicing medicine throughout our broad land. 

THE X RAYS. 

The discovery <'t" the X rays by Professor Rontgen of Wurtsburg 
w&6 announced during the preparation of this work. It has proved 

t<» be of an usual interest to the scientitic world, and has stimulated 
experimentation in the field of electrical research enormously. 




1.— Photographs of scissors, needles, pins, etc., enclosed in a leather case with metal cor- 
nerpieces. 2.— Dr. William Konrad Rontgen, discoverer of the X Rays, Professor of 
Physics at the Royal University of Wiirzburg. He had only a local reputation before the 
announcement of the discovery of the X Rays but on account of this he has suddenly be- 
come famous 3 — Photograph of a lady's hand, showing the bones, and a ring on the 
third finger, with faint outlines of the flesh. 



THE NEW MEDICAL WORLD. 

The previous employment of electricity for the larger develop- 
ment of light and force is phenomenal, for during the past ten years 
our methods of street travel and lighting have been revolutionized. 
Thus the world had been prepared by the rapid progress of the 
recent past to give this new discovery fitting attention and wide- 
spread notoriety. 

It was at once perceived that the Rontgen discovery would be 
of extraordinary interest to medical men, as its practical side has 
a special bearing upon the further and more complete examination of 
the living tissues of the human body. 

It has been known for many (40) years, that the negative or 
cathode current, when passed through a glass vacuum tube, produces 
a vivid fluorescence. Professor Rontgen discovered that when pass- 
ing a rapidly interrupted current of these cathode rays through a 
glass vacuum tube, some of the rays penetrate more or less certain 
substances and cast a shadow picture upon a photographic plate, the 
distinctness of which depends upon the character of the substance 
exposed. In brief the whole process is carried on by means of a 
Ruhmkorph coil connected with a Crookes tube. The portion of 
the body to be examined is placed between an opening in a disk of 
the tube and a sensitive photographic plate. The rays which pene- 
trate and cause the shadow on the plate may be cathode rays, ultra- 
violet rays, or others associated with them. Just what rays produce 
the picture is as yet not definitely known, and hence the discoverer 
called them X rays, because X is used to denote an unknown quan- 
tity or factor. 

The picture made by the employment of the X rays has received a 
variety of names, but as yet no scientific term suggested seems more 
appropriate than Skiagraph, which literally means a shadow writing. 

The X rays, though imperceptible, readily pass through flesh, 
leather, clothing and other similar substances. They pass less 
readily through bone or metal, except aluminum. Glass through 
which ordinary rays of light pass with much readiness almost com- 
pletely obstructs the passage of the X rays. 

When the human hand or foot is exposed in the manner already 
indicated, a shadow picture is formed upon the photographic plate 
which reveals the outline of the hand, foot or other ]3art exposed. 
In this shadow picture the muscles and soft tissues show only a 
little in their outline, the bones themselves show much plainer, so 
that it is possible by this process for one to see a picture of his 



6 I. IK NEW MEDICAL WORLD. 

own Framework; as though a living person could look upon his 
own skeleton. 

Any foreign body, as a piece of glass, needle, bullet, or other piece 
of metal, is readily detected and located, also any deformity such 
as results from a fracture or dislocation, or an abnormal growth or 
bone enlargement may be discovered so that it may be remedied. 

rp to the present time the hands, feet, forearm, and such portions 
of the body, are more successfully penetrated by the X rays than the 
head, which is surrounded by thick plates of bone on all sides. 

The trunk and pelvis for similar reasons are as yet difficult to 
penetrate, and thus reproduction upon a sensitive plate by this inter- 
esting process awaits other discoveries to perfect the methods 
employed. 

Many improvements for producing these shadow pictures have 
been suggested and attempted with more or less success in nearly 
every electrical laboratory. 

As the matter now stands the discovery of the X rays is a great 
aid in certain diagnoses and promises to render the surgeon espe- 
cially valuable assistance in the performance of his delicate and often 
difficult work. 

II.— MEDICAL STUDY FASCINATING. 

Medical study possesses a peculiar and remarkable fascination! 
Who does not wish to know more about the mechanism of the 
human body, and the laws which govern it, whose keeping bring 
health and delight, and whose violation entails sickness, distress 
and death ? 

What can be of more practical service than to know how to keep 
well and strong, and perpetually young ? 

The owner of a valuable horse is particular about his care, his 

f 1, grooming, shoeing, the tit of the harness, in fact, whatever 

conduces to the good looks and lofty bearing of this noble animal. 
Inasmuch as man is better than the horse, ought he not to receive 
greater attention? It is a pari of our mission to devote such care to 
ourselves ami the race as will conduce to the health, happiness and 
longevity of all. In order to do this, we must devote an intelligent 
Interest t«» a large variety of subjects. Attention must be given to 
leanliness, for frequent baths are necessary to keep the skin in a 
healthy condition. The eyes, the ears, the teeth, tin- hands, the 



THE NEW MEDICAL WORLD. / 

feet, all require especial care. Exercise, rest, clothing, proper food 
for the body and mind, are important. How fascinating ought to be 
the consideration of all these subjects, so intimately are they related 
to the important question of our health ! 

We do not exaggerate when we say that there are no more inter- 
esting subjects than these which relate to medical study, in its bear- 
ing upon healthy men, women and children ; subjects which are 
thoroughly treated in this household work. 



III.— MEDICINE A POPULAR SCIENCE. 

Formerly the physician appeared to have a monopoly of medical 
knowledge, and was regarded with profound veneration. He was 
considered the wisest among men, whether he spoke or remained 
silent. Even the movement of his head in the sick room was 
ominous. This old time veneration for professional men belongs to 
the past. Medical subjects are no longer shrouded in mystery, which 
only the physician cares to penetrate. 

The human body is not, as formerly, but little understood and 
studied by the masses. Even the school children -are now taught the 
rudiments of anatomy and physiology, and many besides profes- 
sional persons know considerable about one or more of the several 
branches of medicine. 

Intelligent people are everywhere discussing hygienic measures, 
the prevention of sickness, the quarantine of contagious diseases, the 
causes of disease, the latest theories, especially the germ theory and 
other kindred topics. Nearly every household magazine, at the 
present time, has its medical department for answering the many 
questions proposed by its readers, and various medical subjects are 
studied and written up, so that medicine to-day, may be especially 
regarded as a popular science. 

This increased interest in medical subjects is to be hailed with 
delight, for the more intelligent the people are concerning these 
matters, the more satisfaction can be derived, and' the greater the 
success which will attend treating their ailments. 

A smattering of medical knowledge is likely to make people fussy, 
superstitious, and the easy victims of prejudice or incompetency. A 
general and cultivated understanding of these subjects renders a per- 
son sensible, self-reliant, and better fitted to act deliberately and 



s THE NEW MEDICAL WORLD. 

wisely in times of emergency and danger. Such persons, instead of 
being frightened, and ready to faint at the sight of a dron of blood, 
render timely and valuable assistance to the injured. 

The more generally medical knowledge can be disseminated, the 
better it will be for the physician, for he is liable to have his best 
suggestions hindered, and his anxious hopes blighted, by the want of 
intelligent co-operation. The physician is sure to experience far 
greater pleasure in his earnest and difficult work, when his sugges- 
tions are helped to the utmost, by intelligent co-operation, and 
his patient is correspondingly benefited. 

Medical subjects, too, of all others, broaden the mind, enlighten 
the understanding, and fit men and women everywhere to better fill 
their places in a world of suffering and misfortune. 

IV.— MEDICAL COMMON SENSE. 

There are usually thought to be several schools of medicine. In 
reality there ought to be only one, and that one broad and liberal 
enough to embrace every method and remedy of positive value. 
Prejudice has done much in the past to prevent the best results of 
medical science. It has been fostered by selfishness, and encouraged 
by ignorance. The age of prejudice fortunately is slowly passing 
away, and yet how few, even at the present time, know that apart 
from pretensions, there is but one field of medical science. The field, 
i< must be remembered, is a very broad one, for there is no patent 
upon medical books, or medical knowledge, and no monopoly of 
these can be created. 

The first requisite of a medical student, as of every other, should 
be a teachable spirit, and he should resolve to receive the truth, from 
whatever source it originates. The untaught mind is like a dark 
room, and we must throw open the shutters and let in the light un- 
hindered. It is fortunate indeed that many a mind is broader than 
its professed creed, and it is to be hoped that every one who prac- 
tices the healing art, is progressive enough to lay aside prejudice, 
ami make use of the very best known remedies, in the very best 
manner possible. 

"here is n<> question but what medicines have sometimes hindered 
the process of recovery, and in such cases better results would have 
been obtained without them. It is as important to know when to 
withhold, as when to prescribe. When medicinal agents are neces- 



THE NEW MEDICAL WORLD. 9 

saiy they should be used in such doses as will assist nature to reach 
the desired result. The law of cause and effect should not be 
ignored ; for it should operate constantly when we attempt to work 
any preceptible changes upon diseased conditions. We must apply 
the same good judgment to medicine which is successfully applied 
to farming or shop-keeping. 

For the reasons given above this book contains no sections upon 
homeopathic, eclectic nor other special methods of treatment. 

It proposes to recognize truth from all reliable sources and any 
remedy sufficiently important to be embodied into this work has not 
been intentionally withheld nor obscured on account of its origin or 
advocates ; the same is true with respect to the medical doses recom- 
mended ; for in all cases where admissible the medium dose rather 
than the maximum has been given the preference. 

The design has been toward a broad, liberal and modern system of 
medical belief and practice. There has been no intention of narrow- 
ing the broad circle of medical knowledge nor of fostering prejudice. 

V.— GENERAL CAUSES OF DISEASE. 

Medical study trenches upon a much wider field than the curing of 
disease. It embraces a large variety of subjects of vital importance to 
the health and well being of the family and community. A consid- 
eration of these topics, so closely allied to medicine proper, cannot 
be omitted without failure to understand the obscure causes of many 
important affections. In order to treat the sick intelligently, one 
must consider the question of diet, exercise, ventilation, clothing, 
climate, proper nursing, and many other subjects related to the wel- 
fare of those suffering from acute or chronic affections. 

It is necessary to study the causes of diseases, in order to learn 
how to bring about their removal. We must understand how con- 
tagious diseases spread, in order to check, successfully, their onward 
march. It is usually necessary to know the cause of a patient's suf- 
fering, in order to administer the proper remedy. 

When sickness invades a family or breaks out suddenly in some 
particular locality, the foremost question is, — What caused the out- 
break ? The physician is not the only person interested in the origin 
of disease. It is a matter of vital interest to the general public. 
Hence, at the present time, others beside the family doctor, are ask- 
ing the following questions : Is the location of this house a healthy 



10 THE NEW MEDICAL WORLD. 

one? Is the cellar clean, dry, light and well ventilated? Is the plumb- 
ing modern and worthy? Is there anything about the house or its 
location that can favor the introduction or assist in developing 
disease? If there is any defect about the sanitary condition of this 
dwelling, can it be successfully remedied? Has it been thoroughly 
disinfected since it gave shelter to contagious disease? 

As population multiplies and becomes more crowded in the large 
cities a knowledge of the causes and the methods of prevention, 
especially of the infectious and contagious diseases, becomes more 
essential to all classes, the rich and the poor alike. 

Questions of no less importance about the water supply, concern 
us all. When we consider that the many outbreaks of typhoid 
fever, entailing upon communities vast cost and large mortality, are, 
or can be traced in nearly ever instance to water polluted b}' infec- 
tious germs, an abundant supply of pure water cannot be regarded 
witli indifference. 

Many diseases are also caused by unhealthy occupations. It is 
essential that those inheriting a debilitated condition of the system 
or who are otherwise unfitted for the dangers and hardships of cer- 
tain callings or occupations should avoid them. 

Mental worry and anxiety exert a depressing influence upon all 
the processes of life. So well is this recognized, that the saying has 
passed into a proverb, that "worry kills more people than hard 
work." It is probable that this well-known fact accounts for the 
many frequent deaths among public men, in the prime of life. Men 
of business, men at the head of great enterprises, politicians and 
statesmen are no doubt often heavily laded with vexatious care and 
exposed to a fatiguing mental strain, which weakens digestion, induces 
insomnia, and causes the prostration of the whole nervous system. 
Many sensitive men, who occupy positions of great responsibility, 
are fearfully fretted and annoyed by needlessly harsh and cruel 
criticisms. Is it a matter of wonder, when they envy the health of 
the daily toiler, whose food, though coarse, LS sweet, and whose Bleep 
LB refreshing? We shall never know how large the list is, of this 
\;i-t number, cut off in the prime of life, in the midst of their activ- 
ities, disappointed, grieved, wounded and broken-hearted. Only 
physicians are able to perceive how widespread are the nervous 
troubles which grow out of our intense activities, our struggles to 
get ahead in the world, the constant worry and perplexity which in 
the heat of the strife is so exhausting. 



THE NEW' MEDICAL WORLD. II 

Our variable and ever changing climate often exerts a deleterious 
effect upon infants, old people and those otherwise debilitated. 

A large number of acute and chronic affections are supposed to 
have their origin in that almost indescribable process which is 
denominated taking cold. 

Intemperance, and other reprehensible habits, should not be lost 
sight of in this enumeration. 

From the intimations of this brief article you will observe that the 
causes of disease form a very complex and exhaustive subject, which 
must receive detailed attention elsewhere, for here we have only 
touched upon them in the most general manner. ' 

VI.— SPECIAL CAUSES OF DISEASE. 

The number of denned diseases is put down as two hundred and 
fifty. Of these, about one hundred are more or less fatal, and add to 
the death rate. In a comparatively few instances, accidents and 
unavoidable calamities, such as storms, floods, earthquakes and light- 
ning, increase slightly, the rate of fatalities. 

But for the fatal diseases, man would, with the few exceptions 
noticed, live a natural life, and die a natural death. 

In old age, death is a natural process, for it is simply conformity to 
nature. 

With but few exceptions, disease comes from without, and like 
a foreign foe attacks the system. This is readily seen in contagious 
diseases, while hereditary diseases, like scrofula and syphilis, appear 
to be exceptions. 

It has been discovered quite recently that contagious diseases 
are due to organic poisons, which enter the system in the form of 
microscopical disease germs from the air or water consumed by the 
individual. These germs find in the human body favorable soil for 
their development, and begin to multiply and so affect the blood and 
other tissues as to cause sickness, prostration, and often death. 

Atmospheric conditions are prominent factors in the causation of 
such diseases as bronchitis, croup and catarrh, and the heat of sum- 
mer and autumn is prominent in causing diarrhceal diseases. 

Some diseases extend .everywhere, while others are found only in 
certain sections. Yellow fever requires a high temperature, while 
consumption is limited by excessive cold. 



12 THE NEW MEDICAL WOKLD. 

A very large number of the well-known diseases are preventable, 
tluir progress can be checked, and their spread limited. In other 
words they can be controlled. 

Diseases resulting from over work can be prevented, because they 
are self induced. Other diseases which result from the habitual 
use of debilitating agents, as alcohol, tobacco, narcotics and poisons 
are preventable. 

Contact with those dreadful diseases which work through human 
passions, as syphilis, can be prevented. This is a foul and dreadful 
disease, for it pollutes all life which it touches and travels down 
to blight the innocent ones of future generations. 

Among the old medical writers the predisposing and exciting 
i-auses of disease were much dwelt upon. When insanity appeared 
in a family through several generations, they said such a family was 
predisposed to mental disease. Other families were predisposed 
to scrofula, others to gout or rheumatism, to epilepsy, to cancer 
and other diseases. The second term, exciting causes, was much 
in vogue. 

Sedentary habits are regarded as the exciting cause of constipa- 
tion. Want of cleanliness is considered to be the exciting cause of 
certain affections of the skin. Poor ventilation causes diseases of 
the blood and respiratory organs, loss of sleep, mental disturbances, 
and improper food taken into the stomach, dyspepsia. Colds are 
generally considered as an exciting cause of many diseases, as croup, 
bronchitis, catarrh, etc. 

The diseases which result from old age should be regarded as 
natural. They are especially heart failure and stomach failure. 
The digestive apparatus is worn out and is no longer able to perform 
it- task. In old age congestion of the lungs is common, owing to a 
weak condition of the circulation. 

Heat produces burns, and excessive heat of the sun, sunstroke. 
Cold causes frostbite, lack of food, starvation. Intemperance pro- 
luces a long train of bodily disturbances. Tobacco and opium 
produce typical diseases, and you are referred to the articles upon 

those topics. 

VII.— BACTERIA OR GERMS IX DISEASE. 

Reference has been made so frequently to the influence of germs 
<>r bacteria in causing disease, that a brief review of a few things 



THE NEW MEDICAL WORLD. 13 

known about them will help us to a more intelligent understanding of 
this interesting subject. The microscope has revealed a vast army of 
life which is invisible to the naked eye, and because the bacteria are 
visible only by means of its power, they are often called micro- 
organisms. So minute are these germs that it has been difficult to 
decide Avhether they belong to the realm of animals or plants. They 
are so small that several hundred of them would scarcely stretch 
across the head of a pin. 

It is only within the last half century that these germs have been 
recognized and studied. In fact such recognition and studv was im- 
possible previous to the perfection of a microscope which would 
magnify three or four thousand diameters. One of these micro- 
scopes reveals a drop of water as an animated skating rink, contain- 
ing many millions of these micro-organisms. 

They vary in shape. Some are spherical or egg-shaped, and these 
are known as micrococci; others are rod-shaped, like a match or 
pencil, these are bacilli ; still others are spiral, like a corkscrew, these 
are spirilla. The rod- shaped are the most common variety. They 
are composed of a cell and enveloping material. It is usual to stain 
them red, blue or violet, in order to trace their outlines more 
perfectly. 

Their movements are accomplished by means of hair-like pro- 
jections or cilia, which have been successfully photographed. 

When the conditions are favorable for these germs they multiply 
rapidly; these conditions are warmth, moisture, oxygen and organic 
matter. The estimate of their multiplying ability is marvelous if 
they encounter no obstructions. 

Fortunately the struggle for life is especially severe among these 
lower orders of microbes, and the weak go continually to the wall. 
One variety may feed upon and destroy another, or one variety may 
become extinct for lack of material to provide nourishment. Some 
are poisonous, and poison each other. Some species are enemies 
and cannot thrive together ; some cannot live without other varie- 
ties, and if separated, die. 

Many of these germs are harmless, so far as the human race is 
concerned, while others are beneficial, and absolutely essential. The 
latter are our invisible friends, and indispensable to human existence. 
Only a few are capable of producing disease, and find favorable con- 
ditions for their development in the human body. 

They may be cultivated like plants and flowers. Some thrive 



14 THE NEW MEDICAL W0BL1). 

in this, others in that medium ; some kinds will grow on a piece 
of cooked potato; some in beef broth; some thrive by means of 
heal ; others can endure a great amount of cold and survive freezing. 

Genus are the agents of putrefaction; they reduce all animal mat- 
ter after death, to dust, and set free all kinds of odors, good and 
bad, sweet and sour. They are found everywhere, but are more 
abundant where putrefaction is going on. They exist in the water, 
in the soil and on all plants, vegetables and fruits. 

It may be remarked that the canning of fruit is simply a process to 
keep out the germs which produce fermentation ; boiling destroys 
them and sealing the can keeps out those that pervade the atmos- 
phere. 

In this connection, it will help our understanding of this Avhole 
subject to define what is meant by a spore. A bacterium that is 
unable, for the time being, to reproduce itself, becomes a spore. 
Spores become dry and lie dormant, like the seeds of a plant, till 
they are brought into favorable conditions for their development. 
These spores aj'e carried about in the air, and float about our rooms 
like particles of dust, as if searching for moisture and a foothold. 
When such opportunity is found, they develop like the seeds of 
plants, and produce a progeny. The dried yeast germs are examples 
of these spores ; they lie dormant until they are introduced into the 
moistened Hour, when they begin to multiply with marvelous rapidity. 

We have already hinted that there are certain varieties of germs 
which, in the human body, produce disease. Their activity liberates 
poisons called ptomaines, which produce fever, sickness and a train 
of systemic disturbances. We shall endeavor to give, in condensed 
form, a few of the leading facts which have been learned about these 
disease producing germs or bacteria. 

The causes of disease have baffled all former ages. When the 
germ theory was first proposed to account for the mysterious origin 
of certain diseases, it had only a few believers, but the more care- 
fully and thoughtfully intelligent persons investigated the subject, 
the more converts to this teaching were multiplied, till at the present 
time all scientists have adopted the germ origin of infectious diseases. 

The revelations of the microscope have banished ancient supersti- 
tions, and brought to light millions of agents which swarm in the air 
and water about us, most of which are not only harmless to tin 
human body, but are absolutely essential to its well being. Some ot 

these germs, however, are found to be always present in certain forms 



THE NEW MEDICAL WORLD. 15 

of disease, and it is believed that they cause its outbreak. There are 
certain diseases which when introduced into a family or community, 
spread more or less rapidly. A small quantity of the disease poison, 
no matter whether introduced into the system in the act of respiration 
or with the food and drink, reaches the circulation, and creates a 
marked disturbance, especially rise of temperature, due to the rapid 
multiplication of this poison, or septic material. The multiplica- 
tion of this septic material resembles the action of yeast, a little of 
which soon permeates the whole mass. It multiplies with marvelous 
rapidity, and produces fermentative changes. One sort of germs 
produces measles ; another, typhoid fever ; another, consumption ; 
still another, small pox ; another, chicken pox ; and so on through 
the large list of contagious diseases. 

These varieties of germs always reproduce themselves, and are 
always true to their kind. The yeast germ always produces the same 
kind of fermentation, the measles germ always produces measles, and 
never small pox. The small pox germ never begets cholera, and so 
on, to the end of the chapter. 

Each variety of germ works under its own special law, but in all 
some general methods are observed. Upon exposure to the disease 
contagia or germs, a certain time is necessary for their development, 
this period is known as the incubation ; during which time the dis- 
ease lies dormant in the body. The period of incubation varies from 
a few hours, as in scarlet fever, to several weeks or months, as in 
hydrophobia. 

Having had a germ disease once, we are not likely to have that 
same disease again. The yeast germ will not work the second time 
upon the same mass. It consumes all the material favorable to its 
growth and development the first time, so that there is nothing left 
for it to feed itself upon in the future. Introduced the second time, 
the germ is most likely to die of starvation, unless new material has 
been elaborated upon which it can subsist. 

In some of these germ diseases the poison or infectious germ, can 
be approached nearer than others, without danger of contagion. In 
small pox or measles it is either necessary to come near the infected 
person, or else in contact with some object, as clothing, that has been 
about or near the sick person, or the dried spores which are capable 
of communicating the contagion. In diseases like cholera and yel- 
low fever, the poison is wafted through the air for some distance. It 
is perfectly safe to pass by a house where small pox exists, and there 



16 THE NKW MEDICAL WORLD. 

is little danger of contracting the disease, but the district even, 
where cholera or yellow fever exists cannot be visited without peril. 

In some diseases, the poison is introduced by means of infected 
drinking water, or the emanations of infected water carried into the 
house by means of sewer gas. Other disease germs must be brought 
into actual contact with the mucous membrane, of which gonorrhoea 
and syphilis are examples. 

Bach year the character of these disease germs is becoming better 
understood. The enthusiastic labor of Louis Pasteur has done 
much to bring about an understanding of the character of bacteria. 
Such infinite painstaking as he has manifested has not been too 
highly rewarded by the eminence he has attained, and the unusual 
honor he has received. Sir Joseph Lister applied the principle 
enunciated by Louis Pasteur to the dressing of wounds. By keep- 
ing disease germs out of wounds, they heal without the develop- 
ment of erysipelas, or the formation, in many instances, of a single 
drop of pus. 

A knowledge of the character of these disease producing germs 
helps us to know what course to pursue in each -case, in order to 
prevent the spread of the contagion. Some are readily destroyed 
by one agent, and others by another. In general, the sick should 
be isolated from the well, and when the disease is over, disinfection 
and thorough destruction of the germs should take place. The 
fumes of burning sulphur destroy the germs of diphtheria and scarlet 
fever; boiling destroys the typhoid germ in drinking water, and 
renders it harmless. Cold destroys the yellow fever germ, and heat 
the small pox germ. 

When proper disinfection is neglected, or when the work is imper- 
fectly done, cases of contagious disease multiply. Disease germs 
are easily destroyed outside of the human body if we only know 
how. They are destroyed with great difficulty after they have 
entered the circulation. It is not wise to imitate the man who 
swallowed a potato bug and then Paris green to kill it. All germ- 
icides are poisons, and can be used to much better advantage 
outside than within the human body. 



CHAPTER II. 
SANITARY SUBJECTS. 



I. The Choice of a Home. — II. The House Furnishings. — 
III. Drainage and Sewerage. — IV. The Air axd Vex- 
tilation. — V. The Water Supply. — VI. Food. — VII. 
Clothing. — VIII. Climate. — IX. Exercise. — X. Lon- 
gevity. 

I.— THE CHOICE OF A HOME. 

u He who has health has hope; and he who has hope, has 

everything '." 

THOSE who have abundant means experience but little trouble 
in the choice of a home. They can select an elevated position^ 
on dry, porous soil, where the surroundings are attractive, and the 
sunlight makes cheerful and healthful the rooms of the house. They 
can have the best drainage and sewerage possible, for there is no 
commodity which money will not buy. They can employ compe- 
tent and skillful architects, to supervise the work of building, and 
carry into effect the most advanced knowledge in respect to ventila- 
tion, plumbing and other hygienic requisites which conduce to the 
health and happiness of the family. 

There is a large and respectable class, however, who cannot select 
the situation and build the house they would like ; they are com- 
pelled to make the best selection possible for a quite limited sum 
of money. 

If laboring men could choose their homes in accord with their 
intelligence and taste, they would undoubtedly prefer elevated and 
healthy situations, dry soil, pure air and water, abundance of sun- 
light, and thorough drainage. Abundant means add greatly to the 
ability of building homes after the most approved patterns ; in fact, 
it is the indispensable requisite for carrying out advanced health 
measures to any marked degree. 



]^ THE NEW MEDICAL WOBLD- 

The truth i-, thai a Laboring man, with a family to support, is 
obliged to provide such a home as his limited earnings will command. 
This is the reason he is so often forced into unhealthy and filthy 
quarters, where the rooms are small and receive but little sunlight, 
where the alleys and streets are foul and odorous. He has not pre- 
ferred for his family, mouldy walls, damp cellars, filthy alleys, 
defective drainage, and a polluted atmosphere, but lie has become 
the creature of necessity, and he lias been unable to escape his en- 
vironment. Between the wealthy and the unfortunate poor alluded 
to, every grade of necessity intervenes. 

Only a portion of the income can be expended for rent; in addi- 
tion f 1. fuel, and clothing must be procured, and a margin allowed 

for incidentals. No family, at the present time, will be satisfied with 
the bare necessities of life. Clothing must not only be warm and 
durable, but it must also be tasty in appearance. The wife feels 
compelled to dress herself and children so as to avoid ridicule, and 
be admitted, at least, to the privileges of common society. A man 
who retains his self-respect cannot permit his family to be regarded 
nor treated as outcasts; it then becomes necessary to conform some- 
what to the customs of the times so far as they are harmless, and to 
be in touch with the people among whom one lives. 

The laboring man who has a family to support, unless he receives 
more than the average wages, must practice a rigid economy. The 
expenses and wages must be in proportion ; for the income must 
equal or exceed the outgo. In addition to the ordinary expenses the 
unexpected is always likely to occur, so that where five dollars were 

planned, ten are often required. Sickness, though undesired and 

unprepared for, is liable to come, and who can deny a sick child the 
luxuries which a fevered or abnormal condition demands. If the 
wife i» sick, expenses multiply rapidly, hired service must do the 

work she so cheerfully performs, and so reluctantly "puts aside. 
These are seme of the odds against which the laboring classes are 
often compelled to struggle in our large cities. The first, most diffi- 
cult, and most important lesson for them to learn i- economy, if they 

would ever become the independent possessors of a dwelling place. 

The problem at first is a hard one. It is not merely t<» live on the 

income, but t«> lay by something each year for the purchase of a 
home. It is easy for a family of average Bice to dispose of a large 
income, when the desires are not restrained, and extravagance pre- 
vented. Everv man ought to look forward, for many reasons, to the 



THE NEW MEDICAL WORLD. 19 

possession of a home. Landlords are often petty tyrants, doing only 
what they are compelled for the health and convenience of the 
tenant. The laboring man, aided by his wife, ought to make a 
heroic effort to escape such tyranny, and become the independent 
possessor of a home, which will conduce greatly to the health and 
happiness of his family. 

The author of this work, a few years ago, attended three cases of 
diphtheria in a tenement house, where an examination of the san- 
itary condition of the premises revealed a desperate condition of 
affairs. The sink drains were conducted, about twenty feet from the 
back door to a surface privy vault, which was overflowing from 
heavy rains and surface water, and the overflow found its way back 
into the cellar, and stood there, a pool of filth about two feet deep. 
From such places, unworthy the name of home, the laboring man 
ought to pray earnestly to be delivered, and so strive to improve his 
condition by rigid and enforced economy, that he can become the 
owner of a more suitable and homelike dwelling. 

Co-operative banks and building loan associations have accom- 
plished much in helping these worthy and scantily paid laborers out 
of then difficulties. In making choice of a home avoid damp, 
unhealthy locations ; do not be tempted into a swamp or peat bog by 
a cheap lot. An elevated position is always preferable for a house ; 
sandy soil or gravel is desirable, sunlight is free, and enters 
wherever permitted, carrying cheerfulness and good health. It is 
a destroyer of disease germs, and contributes more than we are 
aware to cheerfulness, happiness and longevity. Sleeping rooms 
ought to be large, well ventilated and admit abundant sunlight. 
Nearly one- third, of our time is spent in sleep, and to occupy rooms 
which are small, damp, and otherwise unsuitable for such a large 
proportion of time, is to invite rheumatism, malaria and other unde- 
sirable diseases. In buying a home already constructed, examine the 
woodwork in the cellar, this will give you a clue to the desirability 
of the place or the reverse. If you find dampness, mould and decay- 
ing timber, do not negotiate for the premises, no matter how low 
the figures. 

A house is not desirable covered in and about with dense shade. 
Shade trees are delightful a proper distance away, but if too near, 
they render a house damp and unhealthy. 



"ZO THE ITEW MEDICAL WORLD. 

n.— THE HOUSE FURNISHINGS. 

Dust accumulates and abounds in human habitations; it always 
contains undesirable properties, and whatever harbors it and pre- 
vents its thorough and constant removal is, from the standpoint 
of health, undesirable in the furnishings of a home. 

Managers of hospitals have at length learned the best way to keep 
out infectious disease germs. You do not find carets upon the 
floors, paper upon the walls, draperies, pictures and upholstered 
furniture as formerly, because it has been learned at last that all 
these beautiful products of a modern civilization are liable to become 
a menace to the health of the inmates. What is true of hospitals 
would be as forcibly true of all our homes, if they were constantly 
crowded with the sick. 

The objection to woolen carpets, upholstered furniture, draperies 
and such like, is not their convenience, elegance or cost, but it is 
that they become the receptacles of dust, and when stirred or moved 
by a footstep, they send into the surrounding atmosphere a cloud of 
dust and lint which, if destitute of disease germs is; to say the least, 
irritating to the air passages, and unfavorable to the enjoyment 
of perfect health. A hard floor, with mats or movable rugs, which 
are daily shaken, is free from the objections which arise against 
a carpet fastened to the floor and removed for purposes of cleaning 
only once or twice a year. 

All furniture should be plain, chairs cane-seated and without 
upholstery. The less furniture put into sleeping rooms the better for 
health purposes. A matting carpet is cool, is easily cleaned and 
preferable to tapestry or brussels. Draperies and portieres are 
undesirable, for they harbor dust, which, upon the slightest agitation, 
is precipitated into the air, and gives to a person whose air passages 
are especially sensitive, a stuffy, unpleasant sensation, and in other 
instances produces such difficulty of breathing, as to render the 
victim unable to sleep or rest. 

It is the over-furnishing of the homes of the wealthy which makes 
their apartments often more unhealthy than those of the poor, includ- 
ing polluted air and lack of ventilation. When contagious diseases 
gain a foothold in these costly furnishings they are dislodged with 
difficulty, and for this reason, consumption, diphtheria and scarlet 
fever, are often more obstinate and malignant in homes of gorgeous 
interior, than in the humble abodes of the poor. Many die but- 



THE NEW MEDICAL WORLD. 21 

rounded by all the elegances and conveniences of civilization, the 
victims of myriads of disease germs, floating in the respired air, who 
would have recovered in tents by the seashore, or in the pine 
woods, with only nature's soft carpet beneath them, and the sweet, 
pure air and blue sky around and above them. It is quite possible to 
sacrifice too much for elegance, convenience, and the gratification of 
our taste for beautiful and costly furnishings. 

The health of the wife and her vigorous and rosy children, a 
thousand times more than compensate for attention to all these 
details of furniture, whose principal ends ought to be utility and 
cleanliness. In the homes expensively furnished we often find the 
husband the only party whose countenance bears upon it the evi- 
dence of health, and for the reason that he spends a large part of his 
time away from home. The wife appears faded and sickly, and the 
few children, or often lone child, still spared by disease and death, 
are slender, pallid, irritable and unhappy. 

There is no deficiency in what money can buy, but a sad deficiency, 
perhaps, in the best gifts of nature, rosy cheeks, sparkling eyes, 
smiling lips and healthy bloom. 

III.— DRAINAGE AND SEWERAGE. 

These hygienic articles only contemplate the consideration of sub- 
jects closely related to health, with a view to the prevention of 
disease. It is therefore unnecessary, for practical purposes, to follow 
the usual course, and consider drainage and sewerage as two separate 
subjects, the former referring to surplus water about a house from 
rain and damp soils, and the latter to excrementitious matter includ- 
ing the refuse of the kitchen and sink. We will agree at the outset, 
to understand by drainage, all the surplus of water, and the waste 
material capable of fermentation and decomposition, which it is nec- 
essary to remove beyond the reach of human habitation, in order to 
prevent dampness and the pollution of the soil and atmosphere. 
Most of the waste products of human habitations in cities, are 
conducted away in drain pipes aided by the inflow of water. 
These conveying pipes ought to be of sound material, with perfect 
joints. 

Defects in drainage are due to a great variety of causes, among 
which may be mentioned the hasty construction of houses ; the soil 
about them settles, and often disarranges and strains the pipes, and 



22 THE NEW MEDICAL WORLD. 

opens their joints. Drains placed in new or made soils, should have 
the earth packed solidly about them by tamping, in order to prevent 
the dangers which result from injury to the pipes and the escape of 
sewer gas into the cellar or surrounding soil. 

Cheap plumbing is always dear in the end, and that which is 
costly may he spoiled by bad workmanship and prove unsatisfactory 
and unsafe. When doing a job so important as the house plumbing, 
use only good materials, and employ only reliable workmen. It is 
poor economy to scrimp here and get a poor job. Have the best 
plumbing which experience has sanctioned, and have it adequate for 
the demands made upon it. 

Plan for a dry cellar ; if necessary, have it cemented, and place 
tiles below the cellar bottom to drain away moisture, and conduct it 
outside the Avails. Avoid surface sink-drains if possible. When 
there is a system of adequate sewerage, the refuse from the sink 
empties into the sewer. Look diligently to see that these pipes do 
not become loaded inside with grease, and be sure of good trapping 
to keep gases and odor out of the house. Perfect plumbing is such 
a rarity that sewer pipes should never be carried into sleeping rooms, 
nor into the closets which open out of sleeping rooms, for the pur- 
pose of having handy washbowls. 

The water-closet and bath-room should have an abundant supply 
of water, the former should have the overhead flush. The elevated 
cistern should contain several gallons and deliver it with such force 
as to secure thorough cleansing. The "pan"" closet is unsatisfactory, 
filthy, and ought not to be tolerated. It is flushed by a valve in the 
supply pipe, which delivers an inadequate amount of water for 
Hushing purposes and often leaks, wetting the woodwork about the 
Mat bowl. In the modern appliances, the cistern or reservoir is 
elevated and the space about the bowl is left open, which secures 
cleanliness and ventilation; this is a great improvement on the pan 
closet with leaky pipes and a space boarded up about the bowl which 
cannot be easily reached and cleaned. 

Whatever the system of sewerage, make sure that the soil about 
your dwelling does not become polluted with refuse liquids, and be- 
come the breeding place of germs; also make sure that sewer gas 
and unhealthy odors do not gain admittance to your house. 

A few things are absolutely essential for the maintenance of 
health; these are pure aii 1 , pure food, ami pure water. Pure air is 
impossible without pure soil. Water must not be contaminated by 



THE NEW MEDICAL AV0RLD. 23 

proximity of the supply to vaults and cesspools, nor must it be per- 
mitted to absorb sewer gas. 

Proper drainage is of paramount importance to the health of 
a family. It is not always easy to state the precise relation between 
ill-health and improper drainage. It has been proved, however, 
that diphtheria is much more prevalent in damp localities. Damp- 
ness and iilth, while they do not of themselves cause diphtheria, 
seem to furnish the essential conditions by which this disease thrives 
and becomes malignant. Human beings naturally pollute their sur- 
roundings, both the atmosphere and soil ; as population becomes 
more dense the danger multiplies. The unpolluted country with 
its pure air and water possesses the ideal requisites for perfect 
health, while the crowded city where poverty and filth abound, 
offers all the favoring conditions for the development and spread of 
disease. Hence the saying that " God made the country and man 
the town " has long since passed into a proverb. It is well known 
that typhoid fever germs may gain an entrance into houses and 
prostrate the inmates with tedious and expensive disease by means of 
imperfectly trapped sewer connections. 

The nations of the old world have been slow in learning*- that 
cleanliness is an inrportant factor in staying the march of devasta- 
ting diseases ; they have manifested great carelessness in polluting 
with filth the soil and atmosphere about their habitations, and hence 
the plague and other frightful epidemics have swept over Europe re- 
peatedly, leaving in some rare cases not more than one-tenth of the 
population alive, and in other still rarer cases whole districts were 
abandoned to the wild beasts, the entire population dying leaving 
only a desert and desolation behind. During four years in the 
fourth century we learn that the plague or black death, resulting 
from the filthy conditions of life, destroyed forty millions of people. 
The cholera of India is attributed by modern writers to the filthy 
habits of the pilgrims. These diseases together with scurvy and 
typhus fever, are now almost unknown among civilized nations, 
abolished by better health measures and attention to the removal of 
filth and decomposing vegetable and animal substances. It is only 
quite recently that people are beginning to comprehend the causes of 
disease and manifest an interest in those conditions which render the 
existence and spread of disease possible, and it is still more recently 
that they are earnestly trying to master the knowledge which will 
altogether banish many of the contagious and infectious diseases. 



•24 THE NEW MEDICAL "WORLD. 

A few practical thoughts should be thoroughly impressed upon 
the minds of everyone. The removal of all filth from the habita- 
tions of man to some place where it cannot vitiate the atmosphere, 
pollute the water, nor breed disease should be speedily accomplished. 
The drain pipes which carry off the kitchen slops should be securely 
trapped, and in hot weather proper disinfectants should be dissolved 
in hot water and poured into the sink ; copperas is excellent for this 
purpose. Garbage should be removed before decomposition takes 
place and foul odors arise therefrom. "Where there are no 
sewers in the country the slops from the sink should be carried 
away from the house where they may be used for fertilizing fruit 
trees and the garden. In the country all drains should be carried 
far away from the well if it is used to supply water, neither should 
surface water, the result of heavy rains, be permitted to reach it. 

The water-closet in the country should be abundantly supplied 
with dry earth, charcoal or ashes, and these should be freely used so 
as to absorb the liquids and prevent odors. A solution of copperas 
should be used occasionally and no neglect in emptying the contents 
of the receiving box should be permitted. 

People living in the country should remember that typhoid fever 
is more prevalent in small places than in the city, and the conta- 
gious germs usually enter the system by means of polluted water. 
Wherever odors are noticed they should be regarded as signals of 
danger, and receive prompt and efficient attention. It is likely 
that the best methods of drainage have not yet been devised. Some 
method, unprejudicial to health, is needed which will prevent the 
pollution of our rivers and streams and which will enrich our soil by 
using it for fertilizing purposes. 

IV.— THE AIR AND VEXTILATIOX. 

The air performs a very important service in the animal economy. 
It is a mixture composed of nitrogen, oxygen, carbonic acid, moisture 
and small amounts of organic matter. Nearly four-fifths of this 
mixture is nitrogen, which has only the one known office of diluting 
the oxygen sufficiently to render it suitable for the requirements of 
respiration. The most important constituent of the air is oxygen, 
and without tliis vital element no animal life could be maintained. 
Neither could animal life exist in an atmosphere of pure oxygen, 
for it is too stimulating and it has to be diluted very much to adapt 
it t<> the requirements of respiration. 



THE NEW MEDICAL WORLD. 25 

Combustible substances burn with a greatly increased brilliancy in 
an atmosphere of pure oxygen, and many which are not combustible 
under ordinary circumstances will burn freely in such an atmosphere. 

The oxygen which we breathe is the great source of animal heat. 
It gives health and bright, red color to the blood. It acts as a 
stimulant to the brain, the muscles and all the functions of organ- 
ized life. 

Air contains a small quantity of carbonic acid, a varying amount 
of moisture which renders the act of respiration more easy and 
some other substances in small amounts which are quite unimportant. 
Air like water is a solvent of other substances, and for this reason 
is often very impure. The act of respiration adds to the impurity of 
the air about us and soon renders it unfit for use, unless there is 
constant renewal and ventilation. In the act of breathing oxygen 
is taken from the air and carbonic acid is added. A person breathes 
about twenty times a minute, using on an average sixteen cubic 
inches of air each respiration, or nineteen thousand cubic inches 
each hour. Every person may therefore be said to vitiate about one 
cubic foot of air each minute. The combustion of every pound of 
coal consumes the oxygen out of one hundred and twenty cubic feet 
of air. A single candle consumes the oxygen of ten cubic feet of air 
each hour and an oil lamp about twenty cubic feet. A person's sleep- 
ing room ought to contain one thousand cubic feet of air to provide 
sufficient amount for respiration during a single night. It is the 
oxygen of the air which sustains life, and by maintaining a condition 
of slow combustion in the body maintains the animal heat. It also 
comes in contact with the carbon in our stoves and furnaces, and thus 
the process of combustion is carried on and heat is evolved. For 
breathing purposes the purity of the air is of no little consequence. 
Some of the diseases which result from breathing impure air are 
those of the respiratory organs, as catarrh, bronchitis, asthma, 
broncho-pneumonia, etc. 

Wall paper colored by arsenical pigments may give rise to poison 
vapors sufficient to produce symptoms of that particular poison upon 
the occupants of a room. In paint shops the vapors and particles of 
lead may escape into the air in sufficient quantity to produce after 
a long time symptoms of lead poisoning. Those working in quick- 
silver mines often absorb mercurial vapors sufficient to produce the 
symptoms of poisoning. The impurities of the air also produce dis- 
orders of the digestive functions. The air may contain* and trans- 



26 THE NEW MEDICAL WOBLD. 

port disease germs, it maybe loaded with impurities arising from the 
soil or from decaying vegetable and putrefying animal matter, or 
pollution arising from human habitations. It is on account of this 
tendency of the air to absorb impurities and transport them, and to 
carry disease germs, that we cannot be indifferent to the squalor and 
disease of the slums of a city. The health and cleanliness of one 
home concerns every other home in the vicinity, and from a Hygienic 
standpoint every man becomes his " brother's keeper." 

VENTILATIOX. 

As human beings rapidly pollute the air about them, the subject of 
ventilation is of prime importance. The act of respiration removes 
oxygen from the air and in its place is found carbonic acid, ammonia, 
sulphureted hydrogen and. decomposing organic matter. It is main- 
tained that from the moisture in the expired air a very poisonous 
liquid can be distilled capable of producing almost instant death. 
The process of ventilation is to let out the polluted air, and admit 
pure air in its place. In a work of this kind we must consider ven- 
tilation in a practical manner; for we cannot enter into the theoret- 
ical, scientific or chemical study of the subject. This must be left 
to the domain of special works. The dangers from polluted air de- 
mand our notice because they come under the head of the prevention 
of disease. Some of the more immediate and noticeable result- of 
impure air are headache, languor, loss of appetite, faintness, vomiting 
and diarrhoea. It is well known that some persons are more sus- 
ceptible to the effects of impure air than others, usually the weak, 
the debilitated, infants and children showing the first and clearest 
signs of suffering, while the middle aged, the vigorous and strong 
are affected the least. 

Where the blood is thin and deficient and the lung capacity is 
small the results are most marked and disastrous. A skilled person 
can judge much concerning the efficiency of ventilation from the 
appearance of the inmates of the house. Those habitually subjected 

to the influences of impure air reveal a pallid, amende condition, a 
want of color in the face, a peculiar lack of vitality. 

Special attention ought to be given to the ventilation of public 

balls, theatres, churches, and above all in the order of importance, 
schoolrooms. The crowded condition especially of city school- 
rooms and the tendencies and lack of vitality on the part of the 



THE NEW MEDICAL WORLD. 27 

younger children, make them the easy victims of a vitiated atmos- 
phere. It would be better for children to remain partially unedu- 
cated, than to be poisoned, dwarfed and ruined by the pollution of 
schoolroom atmosphere. 

An item which interferes with ventilation in cold climates is the 
expense. The changing of the air means the loss of heated air and 
the incoming of cooler currents to take its place. Heat is expensive, 
school boards and other authorities usually vote cautiously and too 
exclusively on the side of economy, rather than on the side of pure 
air, health and incidental expenses. With the poor who live in 
small, overcrowded rooms heated by the cook stove, the question of 
ventilation is often entirely overlooked in the efforts put forth to keep 
from freezing. 

Floating dust is the housekeeper's nuisance. In order to remove 
it from a house spread a line of damp sawdust across the room and 
sweep it before you, or if woolen carpets are to be cleaned, dampen 
the sawdust with a carbolic acid solution. In this way cleanliness 
and disinfection can be combined. After sweepings damp cloths 
should be used to remove the remaining dust from furniture and 
woodwork. It aids very much in removing the dust to open the 
outside doors and windows while sweeping, as the air loaded with 
dust and lint, is driven out by the incoming currents. The dust of 
rooms is composed of a great variety of pulverized substances in- 
cluding filth and lint, and is to say the least, irritating to the air 
passages. It may become quite an important factor in chronic dis- 
eases of the nose, throat, bronchial tubes and lungs. It is important 
to drive it out of the house. 

In considering the dangers which threaten human abodes, almost 
a monopoly of attention and interest have been given to sewers and 
the drinking of polluted water,. Contagious diseases, however, are 
not transmitted by odors nor by air contaminated by the decomposi- 
tion of vegetable or animal matter in sewers or elsewhere, unless the 
specific germs of contagion are present. Decaying cabbages or 
potatoes are unhealthy and render the air unsuitable for respiration, 
but they cannot convey diphtheria nor other infectious and conta- 
gious diseases, unless in addition the germs are present which pro- 
duce the infection or contagion ; as, however, they furnish an 
excellent hiding-place for disease germs, ventilation demands the 
removal of all decavino- substances from the cellar and all the filth. 
and mouldy articles which are so prone to accumulate even in the 



28 THE NEW MEDICAL WORLD. 

best regulated homes, in cellars, pantries, dark passages and out 
of sight places. 

The air of the cellar constantly penetrates the other rooms of the 
house and it should be made sweet and wholesome at all times by 
ventilation. It is unkind to charge Providence with the results of 
our filth, impure air and laziness. Mould and mustiness in the cellar 
are danger signals and should be driven out by persistent ventilation 
and an abundant use of whitewash. 

Anything which vitiates the atmosphere rendering it unfit for 
respiration, must be considered as an indirect cause of disease, and 
hence there are many apparently insignificant matters often over- 
looked in the sanitary inspection of health boards, which are of vital 
importance practically. There are many people who possess a bad 
breath, the result of decayed teeth or an untreated catarrh. All 
these causes of polluted atmosphere are easily remedied, but require 
attention to additional matters aside from thorough ventilation. 
Some one has properly said that "the price of a healthy, clean 
breath is eternal vigilance and a toothbrush." Five minutes de- 
voted to cleaning the mouth and teeth after eating would add much 
to the sweetness and cleanness of many a home, and those who can- 
not spend that amount of time in the interest of sweetness must be 
sadly overworked. A few pennies spent for one of the remedies 
recommended for nasal catarrh will remove the disagreeable odor 
from that filthy disorder, and those who cannot afford the amount of 
money required in the interest of a sweet breath must be poor indeed. 

If a person's teeth, mouth, nose and skin are in such a condition 
as to perceptibly scent the air, the effect must be injurious to the per- 
son himself. As the odor does not come from the lungs, the foul- 
mouthed not only breathe out but also breathe in polluted air into 
their own lungs; hence they poison themselves and become a nui- 
sance to others. 

.Many workingmen smoke old, filthy pipes. Wherever they <_ro they 
taint the air with sickening odors. If thev enter your home for only 
a tew minutes you are obliged to open the doors and windows to 
drive out the intolerable and indescribable stench left behind them. 
They pollute the cramped apartments of their own home and render 

it unlit for a human being. In the winter when fuel is expensive 

and pure air is shut out as much as possible, and ventilation is disre- 
garded, think of crowding a family of four or live persons into 
such a stilling place to live and obtain the oxygen needed from 



THE NEW MEDICAL "WORLD. 29 

such an atmosphere. Add to these quarters the smoke and odors of 
cooking and you have a condition of affairs that is truly loathsome. 

Just think what a struggle an infant must have, introduced into 
such an atmosphere at the sensitive period of birth. No wonder 
the inmates look yellow as if cured by the smoking process. Imagine 
the germs of contagious diseases introduced into such polluted quar- 
ters, and fancy if you can, what the doctor has to contend with. Is 
it any wonder that the disease is often superior to his drugs ? It is 
fortunate if he has positive views in regard to sanitary conditions, 
and smashes out a pane of glass or opens a window and drives out 
the vile air by the incoming of some that is lit for respiration. This 
will be of nearly as much service as any medicine he can prescribe, 
and will probably aid the working of his prescription so as to give 
a fighting chance for victory. 

Some of these matters affect more intimately the welfare of the 
homes of the laboring classes than anything ever touched upon by 
health boards. There are no subjects of more vital importance to 
the homes of the poor than cleanliness and ventilation. In Iceland 
where the houses are destitute of all devices for ventilation, we are 
told that the odor which arises from the herding together of human 
beings and animals, the refuse of fish and the filthy habits, is beyond 
description, and the infant mortality terrible. Births equal the aver- 
ages in other places, yet population is decreasing, for the majority 
of children born die within twelve days of an endemic disease gen- 
erated in the foul atmosphere. It is said that a similar condition of 
affairs exists in the Hebrides Islands. 

The remedy for foul cellars, house odors and musty parlors is ven- 
tilation. Bedrooms and bedding should be exposed to the sunlight 
and air. Faded carpets are more desirable than faded children. 
Fresh air and sunlight are not only the best disinfectants known, but 
are the cheapest; for they will save the doctor's call and may pre- 
vent the Angel of Death from spreading his dark wings over the 
household. 

V.— THE WATER SUPPLY. 

The estimated amount of water required for the use of each per- 
son daily, including the bath and closet, averages twenty-five gallons. 
This estimate is, as it should be, abundant. In all large cities the 
water from wells except artesian should be avoided ; for it is 
usually polluted by surface drainage and in very deep wells the 



30 THE NEW MEDICAL WORLD. 

water is warm and dissolves impurities. In small communities even, 
the water is liable to become contaminated and produce sickness. 
Wells should be removed away from all dangers of pollution by 
barn-yards, privies, cesspools and sink drains. Water absorbs am- 
monia gas, pliosphureted gas, sulphureted hydrogen, and other 
impurities. Chemically considered all water is impure, but not suf- 
ficiently so to prevent its healthful use for drinking purposes. 

Great care must be taken in cities to prevent water from absorbing 
sewer gas. Water which contains decomposing nitrogenous matter 
is polluted by sewerage and unsuitable for use. 

Lead pipes are unhealthy conductors of water, especially if it con- 
tains as an impurity lime in solution. Rain water dissolves lead to 
some extent. A larger amount than one one-hundred and fortieth 
of a grain of lead in a gallon of water renders it unsuitable for 
drinking purposes, and if the use of such water is continued for a 
long time, symptoms of lead poisoning are liable to intervene. 

The analysis of water is not as usually supposed a very simple 
process. There are a variety of methods of purifying water. When 
mixed with clay and vegetable matter it may be allowed to stand 
till the foreign matters settle, when the upper portion can be re- 
moved. A lump of alum dissolved in a bowd of water curdles the 
vegetable substances and carries the impurities to the bottom. The 
amount of alum must be so small as not to be tasted. This method 
on a small scale is made use of in purifying the water supplies of 
many cities and large towns at the present time. 

It is claimed that when water to which the proper amount of alum, 
one-third of a grain to each gallon has been added, has passed 
through a filter every trace of it disappears, the alum uniting accord- 
ing to this theory, with the organic matters in solution forming a 
coagulum which the process of filtering removes. 

A small amount of permanganate of potash may be added to water 
just sufficient to give it a pink tinge. If the water does not change 
the color of this addition there is no organic impurity contained in 
it to occasion fear, and it may be safely used for drinking pur- 
poses. 

I 'nrc water may be obtained by the process of distillation, and 
this method is employed by the druggist. 

Freezing water into ice purifies it only in theory, and hence ice 

taken from rivers polluted by sewerage is unfit for household purposes. 

Water is sterilized by boiling, as there are no germs that can sur- 



THE NEW MEDICAL WORLD. 31 

vive the process of boiling water for ten minutes. This is the most 
important of all methods for domestic use. Water raised to the 
boiling point for a short time and then cooled is safe for sick or well 
persons to drink as freely as needed. 

The filtering of water through charcoal and sand removes the 
solid matters. This is a valuable method and much employed. It 
will not, however, remove everv element of danger in waters con- 
taminated by sewerage, and for this reason the boiling of water is a 
means of great safety. 

Rain water collected in cisterns and filtered through charcoal and 
sand is in many sections abounding in minerals the most healthy 
water that can be obtained. A good filter can be extemporized by a 
little ingenuity which will serve an admirable purpose. Take a 
barrel, fix in a faucet near the bottom ; a few inches above the bot- 
tom put in a false bottom full of holes and over this stretch a layer of 
flannel. Then put in a two-inch layer of clean gravel, and above this 
a layer of pounded charcoal. Repeat this process, adding a layer of 
clean, small gravel and then a layer of charcoal, till within one foot 
of the top of the barrel. The last layer should be gravel covered 
with another layer of flannel held in position by half a dozen clean 
stones, so as to hold all in place when a bucket of water is turned 
in. Draw off the filtered water from the faucet. 

Spring water, which is not too heavily charged with minerals, and 
coming from elevated regions above and beyond human habitations, 
is healthful. TVater is decomposed into hydrogen and oxygen by 
means of electricity, for the purposes of experimentation ; there 
being just twice as much hydrogen as oxygen by measure. 

Pure water is destitute of smell and taste and is colorless except 
in large quantities, when it has a bluish tinge. Water is constantly 
evaporating from the surface of the earth and passing into the air as 
an invisible vapor, so that the air is always more or less charged with 
moisture. This vapor is condensed in the higher and cooler currents 
of the atmosphere, and descends to the earth again in the form 
of rain. 

TTater unlike most other substances is expanded by cold, and this 
fact is of very great consequence, as otherwise ice would settle to the 
bottom of rivers and lakes where the rays of the sun could never 
melt it. 

Impure water, especially that contaminated by sewerage, causes no 
little disturbance to health, such as loss of appetite, dyspepsia, gas- 



?i'l THE NEW MEDICAL WORLD. 

tritifi and diarrhoeal diseases. The breaking out of diarrhoeal affec- 
tions in any community ought at once to direct attention to the 
water supply. It lias already been noted that the germs of typhoid 
fever and cholera may be introduced into the system through the 
pollution of our water supply with human dejections. Stomach 
worms also gain an entrance into the system through unsuitable 
drinking water. How important then to the health and well being 
of every family is the consideration of this subject. 

VI.— POOD. 

Waste and repair are the phenomena which characterize all animal 
life. Every process of thought or motion, whether voluntary or in- 
voluntary, involves destruction of tissue. The more vigorous the 
thought or muscular activity, the more rapid the process of waste. 
The activities of the student's brain, the anxieties of the man of busi- 
ness, the sedentary occupations of the professional man, consume 
force and produce bodily waste as well as the muscular efforts put 
forth by laborers in swinging the scythe, lifting the sledge or follow- 
ing the plow. The involuntary movements of the lungs in breath- 
ing or the heart in maintaining*; the circulation consume a certain 
measure of force, and this force is produced by the combustion and 
destruction of tissue. 

Nature is constantly demanding fuel for her fire. The lungs bring 
fresh oxygen to the blood nearh T twenty times each minute ; for oxy- 
gen being essential to combustion, a constant and never-failing 
supply must be provided. It would be inconvenient, however, to 
eat food as constantly as we breathe, and so a stomach or receptacle 
for food is provided, and by eating at intervals, usually about three 
times a day, enough for nutrition is stored up to meet the require- 
ments of the body in repairing its wastes, and hence an equilibrium 
is maintained both of nutrition and animal heat. When the store of 
food in the stomach is exhausted, nature admonishes us by a feeling 
of hunger and thirst, a desire for food and a relish for it, which 
makes the gratification of the appetite in health one of the most com- 
mon pleasures of living. 

When we consider what a complex piece of machinery the human 
body is ami that whatever enters into its composition must be sup- 
plied from our food, it seems as though it would be essential to 
employ a chemist to preside over the culinary department of the 
household, and instruct the cook in order that our food may contain 



THE NEW MEDICAL WORLD. 33 

lime, sulphur, magnesia, soda and potash for the muscles and bones, 
phosphorous for the brain, iron for the blood, together with other 
mineral salts and acids which unite to build up a human body. The 
chemist, however, can be dispensed with because nature has antici- 
pated all the requirements of the body, in the great variety of foods 
placed at our disposal and if the appetite is normal and the food 
supply is not too scanty and too limited in variety, she can develop 
and maintain a healthy body, but if some abnormal development of 
the appetite exists so that the food demanded by nature is loathed,, 
or there is poverty in the amount and variety of food, then diseases; 
of nutrition may develop, as rickets, a crooked spine, ansemia, gout 
and scurvy, while under such conditions the course of scrofula and 
consumption is greatly accelerated. 

Where the food supply is abundant, very little attention has to be 
given by the individual to the consideration of its constituents 
or as to whether it contains the essential elements required by the 
body. For the appetite will be a safe guide, unless it has been pam- 
pered and spoiled like some only child by too much indulgence. 
The appetite is not an infallible guide, since it must be controlled, 
especially in children, by persons of reason, good judgment and 
experience. It is safe to gratify the appetite to a reasonable extent 
by good wholesome food of which persons rarely over eat. 

The danger of over eating is not from the appetite, but from 
the arts of the cook by which foods are made too rich, too highly 
seasoned or too concentrated for the stomach. As a rule the plainer 
and more simple the preparation of food, the more wholesome it is, 
and the less danger there will be of overfeeding. We can already 
see why suitable, nutritious and wholesome food is such an impor- 
tant factor in preserving the health of individuals and families. A 
thorough study of nutritious and wholesome food involves a con- 
sideration of the chemical composition of the various articles of 
diet; but this cannot be entered upon in a work like this, which cov- 
ers so great a variety of subjects in a single volume. It will be suf- 
ficient to give a few practical hints, and direct those who wish to 
study the subject further to special works on physiology. 

As to the disputed question in regard to animal foods, the vegeta- 
rian contends that vegetable foods only are intended for use, that the 
slaughter of animals is cruel, repulsive and wicked. He does not, 
however, hesitate to partake freely of milk, eggs, cheese and butter. 
As these belong to the list of animal foods, even those who profess 



34 THE NEW MEDICAL WORLD* 

to be vegetarians are so only in name. Experience teaches that a 
mixed diet of meat and vegetables is the most natural and wholesome. 
Too large an amount of animal food causes congestion of the liver, 
and probably enlargement of that organ. Sedentary persons and 
the aged, who use too much meat, develop a tendency to gout, disor- 
ders of the blood, degeneration of the arteries and apoplexy. An 
excess of foods containing fat, produces bilious troubles and obesity; 
while a diet of rice and starchy foods requires the consumption of too 
large an amount in quantity to satisfy the bodily requirements; and 
the development of body and mind in nations too exclusively con- 
fined to their use, is notably inferior. Good milk contains all the ele- 
ments of nutrition and is an excellent and nutritious article of food. 
Of all foods it is the most suitable for infants prior to dentition. 

The two great classes of foods required by nature are the nitrog- 
enous foods, so called because nitrogen enters largely into their com- 
position, and the carbo-hydrates or non-nitrogenous. A human 
beinof could not thrive on an exclusive diet of either. The nitroge- 
nous foods are represented by muscle or lean meat, fish, the caseine 
of milk, the gluten in bread, the albumen of the egg, beans, peas and 
other vegetables. These also contribute to the formation of muscle 
or flesh, while the carbo-hydrates are represented by starch, sugar, 
oils and fats. These latter are the heat ami fat producing articles of 
food. They unite with oxygen in the body and produce a slow com- 
bustion, by which heat is evolved. The heat of the body is main- 
tained <luring summer and winter at an even temperature of 98| 
degrees. 

It must be remembered that many articles of food contain both the 
muscle or flesh forming and fat producing elements, as well as small 
amounts of minerals required by the body. The cereals also contain 
phosphates; potatoes, cabbage and other vegetables contain the salts 
of potash; beets and other vegetables contain iron; the yolk of an egg, 
sulphur; meat contains, in concentrated form, food for the muscles 
and brain and the same mineral constituents as are required by the 
human body. The most substantial, nutritious and easily digested 
meats arc beef and mutton, and none are more healthy. Water and 
common salt are among the important articles which are required tot 
the nutrition of the body, a large proportion of which is water. Water 
agists in the digestion and assimilation of food; for it is nature's 
solvent. It keeps the blood in the proper fluid condition, so that 
new material can be carried to build up the tissues, and it dissolves 



THE NEW MEDICAL WORLD. 35 

the waste products and holds them in solution so that they can be 
removed by the kidneys, bowels, sweat glands and the lungs. 

The art of cooking has much to do with the digestibility and appro- 
priateness of the diet. Many foods would be unsuited to our use 
unless cooked. It is to be remembered that foods may be injured 
and made indigestible by improper cooking. Fried foods and arti- 
cles permeated by grease are difficult to digest, and are certain to 
overtax and distress the stomach of the student and others of seden- 
tary habits. Heavy bread, strong tea and coffee, alcoholic stimu- 
lants, and many other things which could be mentioned are injurious 
to the stomach and detrimental to the health. 

It is not necessary to purchase the highest priced pieces of meat 
in order to obtain healthy food. The cheaper pieces are toothsome 
and nourishing when properly cooked. The succulent vegetables 
should be sound and fresh, and in such condition are healthy and 
desirable. Meats should be used before becoming tainted; and stale 
eggs are very undesirable for food. The foods prepared for our use, 
of whatever kind, should be sound and wholesome, properly cooked 
and deliberately eaten. The variety should be sufficient and the 
amount abundant in order to supply all the elements which nature 
requires to produce cartilage, bone, muscle, brain and nerve, and to 
supply the force which our activities of body and mind constantly 
expend. Muscular force and nerve force we consume more 
rapidly and lavishly than less civilized nations. When the food sup- 
ply is just sufficient to repair the wastes of the body and maintain 
the tissues, the bodily weight remains constant, if the food supply is 
inadequate, the weight diminishes; and when the food supply is taken 
in excess, the weight is liable to increase. When this latter process 
is going on too rapidly, the amount of food should be diminished, 
and exercise increased. Nature makes considerable provision for the 
removal of the surplus food material which she does not require, and 
rigorous exercise favors the process. 

Persons who are accumulating flesh or fat too rapidly, ought to 
diminish the luxuries of the table and increase their out-door activ- 
ities. The danger of taking too little exercise is greater than of tak- 
ing too much food. 

The amount and quality of food required is influenced consider- 
ably by the occupation and climate. Those who perform severe 
manual labor require a substantial diet of both the muscle and fat pro- 
ducing foods. In cold climates more food is consumed, especially 



:jt) THE NEW MEDICAL WORLD. 

the fats and oils; for nature demands these in order to maintain the 
animal heat. In temperate elimates more of the fat producing foods 
arc used in the winter to supply the demands of nature, while in the 
summer, fruits, berries and vegetables are more plentiful and their 
increased use more appropriate than fat meats. Every person 
requires some fat at all seasons, but as scarcely anyone eats bread 
without butter, or potatoes without gravies, this demand is supplied 
in our ordinary diet. 

The action of the saliva, the secretions of the stomach, the pan- 
creas, the bile and the intestinal juices upon the food belongs to the 
subject of digestion, and is mentioned in its appropriate place. 

Tea and coffee are largely used throughout the civilized world. 
They are somewhat stimulating in their effects and prevent waste of 
muscular and nerve tissue. It is a well-known fact that those using 
tea and coffee consume less solid foods. When used, the amount 
should be moderate and if nervous troubles are developed or aug- 
mented, their use should be restricted, or even discontinued if neces- 
sary. Coffee, as well as tea, is a quiet stimulant to the nervous 
forces. It quickens the intellectual faculties, aids digestion, invig- 
orates not only the brain but also the body and increases mental and 
physical endurance. The drinking of coffee at night usually pro- 
duces wakefulness. Good coffee can be obtained only by buying it 
in the kernel. It should not be too coarsely nor too finely ground. 
It is best made by adding boiling water and should be prepared as 
wanted, for if boiled too much the delicate aroma is dissipated and 
restaurant or boarding house coffee is the result. Both tea ami cof- 
fee contain tannin, and too much boiling extracts this undesirable 
astringent, which produces constipation. Cocoa makes a nutritious 
and healthy drink when properly prepared. 

Children should not be allowed to drink tea and coffee. In their 
stead they should be supplied with milk, which is not stimulating, 
more nutritious and much better adapted to their needs. Feeding 
the sick is treated elsewhere, as it forms an important .part in their 
recovery and restoration. 

VII.— CLOTHING. 
If this subject had no bearing upon the prevention of disease it 

could be dismissed with few words. The relation however between 
clothing and health is so intimate ami important as to demand recog- 



THE NEW MEDICAL WORLD. 37 

nition. The uses of clothing are so numerous and the services it 
performs so manifold, that it ought to awaken the interest of all who 
are solicitous about the preservation of their health. 

As made use of in civilized countries its principal office is to cover 
and conceal the person, except the hands and face and a portion of 
the head. In a narrow and heated belt of the tropical world, savage 
tribes almost wholly dispense with clothing and in consequence are 
but little burdened with what in civilized countries constitutes a con- 
siderable item in the column of expense. 

Many of the animals have a covering of hair which protects them 
from the changes of climate, adapting them to the heat of summer 
and the cold of winter. In the early fall winter's approach is antici- 
pated by a luxuriant growth of the fur which becomes thick and 
heavy. Near the approach of spring the shedding process occurs 
and the hair falls rapidly and thus the heat and cold are anticipated 
and provided against yearly. Man has a similar protection for his 
head but the wearing of fashionable hats and other effects of modern 
civilization have an unfavorable influence upon the hair, the bulbs 
are injured and the hair often falls from the crown and dome of the 
cranium by or before middle life. 

Civilization appears to be especially destructive to the teeth and 
hair. 

Another use of clothing is protection from external injuries, but 
especially from the effects of heat and cold. In the temperate and 
frigid zones protection from the rigor and changes of the climate is 
a necessity. It is doubtful whether human beings could be suffi- 
ciently toughened to endure the variations of the climatic changes of 
the temperate zone even, without clothing. The colder and more 
changeable the climate the more apparent and forcible is the neces- 
sity for suitable clothing. It is a well-known fact that the body 
becomes heated by exercise and in this condition the pores of the 
skin gradually open wider, the sudorific glands are stimulated by 
warmth to increased activity and a large amount of moisture is car- 
ried to the surface of the body, where evaporation takes place rap- 
idly in order to lower the temperature and establish an equilibrium. 

In this relaxed condition clothing prevents cold currents of air 
from coming in direct contact with the skin, the results of which 
would be a shock of the cutaneous nerves, a rapid flow of blood to 
the internal organs with congestion of the same, chillino; of the sur- 
face and the taking of a cold which so often proves disastrous. 



38 THE NEW MEDICAL WORLD. 

Another important use of clothing is to prevent a rapid escape of 
the animal heat. This is lost in two ways, by evaporation and radi- 
ation. When evaporation is too rapid the surface is cooled too 
quickly, the body is chilled and often with serious consequences. 
Clothing then has its most important use in retarding the cooling 
process. Those fabrics are most suitable for clothing which are the 
poorest conductors of heat, as they most retard evaporation and 
radiation. 

Among the poor conductors of heat are silk and woolen, while cot- 
ton and linen represent the opposite quality. Owing in part to the 
expensiveness of silk, woolen may be regarded as the best known 
material for many articles of wearing apparel. It has great affinity for 
that moisture and retains it in large amount. It is owing to the fact 
evaporation goes on so slowly from its meshes that one does not feel 
cold and clammy after sweating, as is the case with muslin or linen. 

It is the slow evaporation of moisture from woolen which renders 
flannel so comfortable for summer wear. Clothing itself is neither 
warm nor cold. Its serviceable use in winter depends upon its abil- 
ity to retain the bodily heat and in summer to prevent rapid evap- 
oration of moisture. Woolen clothing meets both these require- 
ments, for it is porous, containing air in its meshes and hence does 
not permit heat to escape like cotton or linen. 

Another use of clothing is adornment. This in civilized countries 
occupies much thought and attention, and often overthrows the best 
teachings respecting its sanitary use. Fashion is often averse to the 
more legitimate use of clothing, but so much has been said in this 
line as to render its repetition uncalled for and hackneyed. 

The essential requisites of clothing are comfort and warmth. Men 
are more apt to dress comfortable than women; for they ordinarily 
pay less attention to the dictates of fashion and would not hesitate to 
violate her mandates if she ventured to interfere too perceptibly with 
male attire. Men do not gracefully submit to discomfort and violate 
the laws of health, since they are not as patient and resigned in tribu- 
lation and suffering as their less complaining sisters. 

The appearance of women at receptions in winter with the fash- 
ionably low cut dresses which expose the throat, chest and arms, if 
in good taste, sadly conflicts with every requirement of health. 
Whatever violates the sanitary demands of clothing should be aban- 
doned as unbecoming and unsuitable no matter what other advan- 
tages may be claimed. 



THE NEW MEDICAL WORLD. 



39 



Clothing should be worn sufficiently loose to permit full play and 
natural movement of all the muscles of the body. To dress other- 
wise or to constrict the waist and change the form which nature has 
chosen as most fitting is foolish indeed, and entails a large amount of 
suffering in the aggregate. Intelligent* persons at least ought to 
know that a slight waist detracts from the graceful appearance of 
the human form. Nature needs no remodeling and reshaping with 
ribs of bone and steel. Life at the best is full of suffering ; why 
multiply our sorrows or shorten our days ? Tight lacing produces, 
by unnatural pressure, injurious effects upon the delicate abdominal 
organs which cannot escape displacement. It limits the expansion 
of the thorax, interferes with the play of the diaphragm, the great 
muscle of respiration, which ought to be free to rise and fall with 
every breath. Digestion, circulation and respiration, the three great 
and essential functions of animal life, all suffer evil consequences. 




Fig. 1. 




Fie. 2. 



Figure 1. — Bones of the chest in their natural relations. 

Figure 2.— Bones of the chest which have been distorted by tight lacing 

Whatever impedes the circulation though it be only a tight garter, 
a close-fitting glove or shoe works mischief and obstructs the 
return circulation of the venous blood. A thing so apparently tri- 
fling as a snug garter easily works injury to the valves of the veins 
in the lower extremities and causes varicose veins and ulcers. One 



40 THE NEW MEDICAL WOULD. 

thing Leads to another and it is easy for those who understand the 

delicate structure of the animal tissues to trace the connection 
between impeded circulation and a reduced vitality, and to trace the 

relation between tight clothing and pneumonia, consumption, pal- 
pitation, dyspepsia, biliousness and the derangement of other del- 
icate organs. 

We <lo not maintain that the errors in clothing are always the 
cause of the diseases mentioned and many others, but in so far as 
the vigor and vitality of the bodily forces are depressed by clothing, 
it becomes a recognizable and important factor in the development 
of many diseases which could be avoided by a judicious obedience to 
the teachings of physiology. 

Young persons often fail to appreciate the value of good health 
and stand ready to sacrifice it for what they believe to be an improve- 
ment in external appearance. This is often the result of thought- 
lessness or a lack of right knowledge. Experience teaches that 
health maybe easily sacrificed, vital force may be lavishly squandered 
and life cut off before the noontide hour. The teachings of experi- 
ence usually come too late to rectify the mistake. There are but few 
persons who are ready to profit by such suggestions. Many are 
more ready to take pills, powders and potions of bitter drugs than to 
receive and profit by good advice. 

It is astonishing to observe the low estimate placed upon health 
until, like Esau's birthright, it has been foolishly bartered away when 
it cannot be bought back at an enormous price. 

There are a few other general facts in regard to clothing which are 
usually well understood. Dark colors absorb the heat from the suifs 
rays more perfectly than light colors and hence the former colors are 
more suitable for winter wear and the latter for summer. As the 
exhalations from the body permeate the clothing it should, as well as 
bedding, be exposed to the air and sunlight frequently or cleansed by 
washing. Clothing is sometimes irritating to the skin and if the irri- 
tation is continued produces diseases peculiar to that organ. Such 
defects, as soon as observed, should be remedied. 

VIII.— CLIMATE. 

The subject of climate cannot be treated exhaustively here, neither 
is it necessary. There are special works on climatology which <_i'o 
into thousands <>t" details that only interest th >se making a special 



THE NEW MEDICAL WOELD. 41 

study of the subject. There are also many articles in all the ency- 
clopedias on this and kindred topics. Climate is of interest to us 
from a medical standpoint and we shall briefly consider it in its rela- 
tion to health and disease. 

Man has the faculty of adapting himself to a great variety of cli- 
mates. He is able to live in the frozen north amid snow and ice, 
where his clothing must be the skins of animals and such material as 
will prevent as much as possible the radiation of heat. He is on the 
other hand able to live in tropical regions where the heat makes 
clothing almost intolerable. 

The two extremes of heat and cold are not as favorable for the 
best race developments as the temperate climates. In the northern 
or arctic regions the struggle for life is too severe, the products of 
the earth are scanty, the races are stunted, dwarfed not only physi- 
cally but also intellectually. In the tropical regions vegetation is 
luxuriant, nutritious fruits are produced in abundance with the mini- 
mum of labor, man has to put forth but little effort to secure a liv- 
ing and he does not have to store up fuel and provisions and so the 
tendency is toward indolence and laziness. 

The two extremes, distressing poverty or abundant luxury, are also 
inimical to the best interests of a race. Climate has its bearing on 
these conditions and is a very significant factor in the welfare and 
happiness of the human family. 

Man is effected physically, mentally and morally by his environ- 
ment. This he cannot escape except by change of habitation. It 
determines largely the diseases from which he must suffer. 

High altitudes have a well-known immunity from consumption 
and malarial diseases. Climate is the most important factor in dis- 
eases of the air passages. Catarrh, so troublesome in the Xew Eng- 
land states, especially in winter, is almost unknown in a climate such 
as Southern California. 

Sudden and extreme changes in the temperature work injuriously 
upon many constitutions. The debilitated are the greatest sufferers 
from a variable climate. 

The northern portion of the United States is subject to these try- 
ing variations in a marked degree against which no foresight can 
always provide. There are periods when the climate is that of a 
region far to the south; the air is mild, the sky soft and southern, while 
south winds blow ; in an hour the wind changes and cold currents 
come sweeping down upon our habitations "from Greenland's icy 



A'2 THE NEW MEDICAL WORLD. 

mountain s." The robust brave these sudden variations without 
injury, but persons suffering from diseases of the air passages or lungs 
are greatly depressed, and sometimes the decision between life and 

death is made by such climatic changes. 

The best climate for consumptives, or those suffering from chronic 
bronchitis, and other kindred diseases is in those regions where the 
greater portion of time can be spent daily in the open air the whole 
year around. This requisite demands pure sky, pure air, dry atmos- 
phere, warm, even temperature and freedom from sudden and vio- 
lent changes. 

Some who are not too far advanced in sickness and who possess a 
Large amount of vigor and endurance improve in cold, salubrious cli- 
mates like that of Minnesota, while others have better chances for im- 
provement in Florida, Arizona or Southern California. Colorado enjoys 
considerable reputation at the present time for consumptive patients. 
It must not be forgotten that change of scene, better health regula- 
tioiis and other minor matters often combine to bring about the 
improvement which follows a change of climate. 

A change of climate often aids indirectly in producing the desired 
improvement; for it may help to increase the appetite, improve the 
digestion, increase muscular exercise, which means increased respira- 
tion and circulation and consequent gain in bodily weight. It i< 
impossible to give rules in regard to change of climate or to specify 
the places suitable for different diseases and persons. No one cli- 
mate is adapted to the requirements of all. Some are benefited by the 
sea aii% while Others are made worse. The best method to pursue in 
regard to change of climate is for each case to seek advice from com- 
petent authority. Our own country contains almost every variety of 
climate modified by altitude, heat, moisture, the ocean currents and 
many other factors. 

Some people prefer other lands and for such there are suitable 
places in Switzerland, France, Italy ami the islands of the sea. N:iv 
sau, <>n one of the Bahama Islands, has the reputation of a mild and 
even climate throughout the entire year. 

Having decided that a change of climate is essential, one should 
give the new locality a thorough trial and not leave before notice- 
able improvement can have time to take place. Winter in a south- 
ern clime and summer in the Adirondacks would afford variety and 
diversion for those who are fond of changes ami can afford the 
expense. * 



THE NEW MEDICAL WORLD. 43 

IX.— EXERCISE. 

There is close relation between exercise and good health. It is 
not merely important but it is essential to the functions of all the 
organs and to a normal ami healthy condition of the Serves and mus- 
cles. 

The beneficial effects of exercise upon the nerves will be seen 
from their relation to all functional activity and every bodily and 
muscular movement. There are two sets of nerves, known as nerves 
of sensation and nerves of motion ; the former receive the outward 
impressions and carry th'em to the brain, the latter transmit the 
impressions to the place where motion or action is essential. The 
brain is the capital center of all nerve force and the numerous nerves 
running to every portion of the body and from every portion back 
to the brain are like telegraph wires carrying messages to and from 
the central office. 

Back of every movement whether voluntary or involuntary is the 
controlling nerve influence ; when this is disarranged there is a cor- 
responding disarrangement of this or that organ or function, as the 
heart, stomach or muscular system. Such disarrangement produces 
dyspepsia, lack of nutrition, constipation, irregular heart action, 
weakness, prostration and a host of diseases depending upon the 
character and degree of nerve trouble. This is sometimes so pro- 
nounced that the whole mental or physical system is shattered and 
not infrequently the whole man becomes a mental wreck. We can 
do little more than suggest here how the nerve force acts and reacts 
upon every tissue and fiber of the body. 

It is well known that motion is produced by the action of the 
nerves upon the muscular libers, causing them to relax or contract as 
necessary. Exercise could not improve the muscular force if it did 
not equally increase and develop the ability of the nerve force. It is 
always the trained nerve which controls the action of the muscle 
fiber. This training of the nerves is the most important result of 
physical exercise. 

Men of powerful muscular development cannot write out their 
thoughts upon paper unless they have learned the process of writing, 
unless the nerves and muscles of the hand have been trained to do 
this work conjointly. Any common handicraft is easy to the trained 
nerve and muscle, but otherwise difficult or impossible no matter how 
great the muscular power. 



44 THE NEW MEDICAL WORLD. 

Exercise is just as much a tonic- for the nervous system as it is for 
the muscular system and just as essential, but this fact is usually lost 
sight of. Exercise is usually considered as having reference simply 
to muscular development, hut let us remember that its relations are 
a- dose to the mind as to matter; for no process of the mind or 
body, no tissue, nothing, can he separated from the nervous system. 
It is omnipresent in the human organism. Hence all exercise 
affects primarily the nervous system and through it secondarily the 
tissues and functions under its control. 

Exercise affects the process of respiration favorably; but think for 
a moment how far reaching such a proposition is. Increased and 
improved respiration means that more oxygen is taken into the lungs, 
that the carbonic acid and other waste and poisonous products of the 
system are more successfully eliminated. This implies purer blood 
and the remotest tissue and fiber of the body feels the exhilaration 
almost immediately. It is not essential for your well being to follow 
up the newspaper advertisements of the dispensers of oxygen for 
there is oxygen all about you, oceans of it, abundant and to spare, 
and you may breathe it in freely and become more vigorous and 
healthy. The Creator who made man and who knows what is neces- 
sary for his well being has put as much oxygen in the air as the 
human body requires, if you will only use it and inflate your lungs 
with it daily to their utmost capacity. 

Exercise increases and improves the heart's action. This, if not 
excessive, sends the improved blood with greater energy and force to 
the extremities, and relieves cold feet and hands far more satisfac- 
torily than sitting over a register to get the hot air from a furnace. 
It is better than medicine in most instances to aid the circulation. 
There is no more satisfactory tonic for a weak heart, purple veins, 
cold extremities and pale cheeks than exercise judiciously taken. 
There is no unfavorable reaction from such a stimulus. It is in keep- 
ing with nature's great remedies and her methods of healing are the 
best yet known, though often the least appreciated. Many who resort t<> 
medicines would derive more benefit from pure air, nutritious diet and 
duly regulated exercise. But how difficult it is to analyze the health- 
ful results which follow nature's processes; they are so complex and 

so Lap on to each other at every point. 

N<>t only the lungs and heart do their work better, but the results 
of exercise are to be traced in that important organ, the skin, spread 

<>ut over the whole surface of the body. It becomes more active, 



THE NEW MEDICAL WORLD. 45 

the pores are opened, copious moisture is eliminated together with 
other waste products which tend to embarrass the system. Every 
organ of the bod}^ is stimulated to a more healthy performance of its- 
functions. 

It is not easy to enumerate in detail what exercise can do in the 
way of maintaining or restoring the health. It increases the demand 
for nutrition, hastens digestion, aids absorption, promotes sleep and 
increases the energy of mind and body. It acts like a balance wheel 
to regulate, equalize and preserve the health. The many ailments of 
the sedentary which render life a kind of prolonged misery can 
be largely prevented, or if in more advanced stages can be cured by 
means of exercise intelligently prescribed and conscientiously admin- 
istered in appropriate and regular doses. Many sedentary persons 
are subject to headache, nervousness, sleeplessness, neuralgia, disor- 
dered stomach, biliousness, constipation, piles and a long list of such 
allied miseries which could be alleviated, if not wholly cured by 
systematic exercise. It is a powerful factor not only in the preserva- 
tion of the health and the prevention of disease, but also in diminish- 
ing the bodilv weight when such result is desirable, in reducing 
deformities and overcoming the weakness of nerves, muscles, parts 
or organs. 

The use of physical culture in all the public schools should be 
encouraged. While the practice is a splendid discipline it also serves 
to relieve the weariness of close application or prolonged study and 
restraint in one position. School children thoroughly enjoy such 
drill and student life is rendered far less tedious than under the old 
methods. 

Feeble persons must omit out door exercise in bad weather and be 
contented with home gymnastics, which can readily be devised with 
a little ingenuity. 

Of two medicines possessing equal virtue that is to be selected 
which is the more pleasant. On the same principle that exercise is 
preferable which will be relished, which possesses the element of diver- 
sion and combines the cheerful employment of the mind and body. 
That exercise which is not enjoyed, like bad-tasting medicine, is more 
likely to be omitted than taken. It is quite essential in order to obtain 
the best results that exercise should be agreeable and much enjoyed. 

Public gymnasiums are preferable to private because the feeling of 
compulsion and restraint experienced causes a more regular and sys- 
tematic pursuit of their benefits. 



46 THE NEW MEDICAL WORLD. 

The danger of carrying exercise to excess must be guarded against. 
It is well known that professional athletes suffer unpleasant conse- 
quences from their occupation. Even the bones suffer injury, the 
joints after a time lose their mobility, the muscles are over-taxed, the 
heart valves are strained and often permanently injured. Exercise 
should be regulated in order to stimulate the bocjy and brain in the 
right proportion. The energy must not be wholly consumed in mus- 
cular exertions. Exhaustive exercise may affect unfavorably not only 
the muscles, joints and heart, but also the brain and nervous 
system. 

School boys and college students are especially liable to carry 
physical exercise to excess. The vying with each other and the 
powerful stimulus to excel often result disastrously. Football is an 
exercise of such severe nature as to be dreaded by the friends of those 
who participate in the game, and it is doubtful if such immoderate 
exertion is ever beneficial, while it often results in minor accidents 
and sprained ankles if nothing more serious. 

Prize contests on the part of athletes should not be' encouraged; 
for the nervous strain is injurious even though the muscles appear to 
endure it unharmed. Out-door games when there is no especial ele- 
ment of rivalry are healthful and invigorating and should be encour- 
aged. Walking is good exercise though not vigorous enough to 
develop the chest and upper extremities. It may be carried to 
excess by beginners. 

Horseback riding has much to commend it as healthful exercise. 
It should alternate with walking as it does not sufficiently exercise 
the muscles of the legs. Walking makes up the deficiency. Rowing 
should be added when practicable, to develop the chest and its mus- 
cles. No one kind of exercise serves for complete development. In 
winter skating is admirable exercise for boys and girls ; it should not 
be too long continued. Bicycle riding is an ideal exercise in which 
all the members of a household can join. From the bicycle, women 
learn the important Lesson of controlling the nerves. "It is a tine 
Bight," says a recent writer, "to see in L896 a woman weaving her 
wheel in ami out among the loaded teams who in 1894 would hardly 
have dared to cross the same street without a policeman's arm. 

When the mother of a family can strap a lunch box to her handle 
bar and convey a brood of young cyclists for a day at the seashore or 
in the woods there is a decided gain in the average health of women. 
The girls, not a few but nearly all of them, are getting OUt-of-doors 



THE NEW MEDICAL WORLD. ±i 

which is precisely what has been wanted for the last two generations 
to give the American race a lighting chance to survive." 

After exercising, the pores of the skin become relaxed and care 
must be taken not to cool off too suddenly. Draughts of air should 
be avoided and friction of the skin with a coarse dry towel is advan- 
tageous. 

The following health code by an unknown writer contains a prac- 
tical summing up of the whole subject, 

"Take the open air, the more you take the better, 
Follow nature's laws to the very letter; 
Throw the drastic pills in the Bay of Biscay, 
Let alone the gin, the brandy and the whiskey. 

"Freely exercise, keep your spirits cheerful, 
Let no dread of sickness make you ever fearful, 
Eat the simplest food, drink the pure, cold water, 
Then you will be well, or at least you ought to.'" 



X.— LONGEVITY. 

" Years steal fire from the mind as vigor from the limb ; 
And life's enchanted cup but sparkles near the brim."' 

— Byron. 

It is the duty of all mankind to apply their knowledge so far as 
possible to right living. Longevity is promoted by a proper observ- 
ance of health laws, but the strictest observance of these laws cannot 
guarantee health or long life to every one. In attempting to dis- 
cover the secrets of longevity, if secrets there are, our research must 
be extensive enough to include certain exceptions, found in the 
foot notes, under all rules. 

For those who inherit a debilitated constitution, a deficit in phys- 
ical force, the problem of longevity appears to be a very difficult one 
and its working out seems to promise only uncertain results. It is 
well known by medical men and actuaries that there is no factor so 
prominent in the subject under consideration as heredity, and yet it 
would be useless to pause and discuss it so far as the present gen- 
eration is concerned, since no one can rectify the mistakes of his 
progenitors. It is everywhere admitted that those who have 
descended from hardy stock, who are by nature strong and vigorous, 
have the advantage, and it would seem as though predictions could be 
made in their favor with great certainty, but we have all noticed that 



4# THE NSW MEDICAL WORLD. 

the strong are often rash and fail to conserve their health, while those 
naturally trail may be 80 cautious and temperate as to outlive them 
and reach a ripe old age. 

There can be no system of living which everyone can adopt to 
insure longevity, but there are many aids which if brought into con- 
stant service offer the best prospect for reaching up to and beyond 
the average expectancy. There are certain general principles that 
experience has taught the thoughtful in every age, which it is advan- 
tageous to learn early and practice persistently. These have almost 
become proverbial and can be stated in a few brief sentences thus: 
take plenty of exercise; bathe often; keep the head cool, the feet 
warm and dry; avoid unwholesome food, impure water, unventilated 
rooms, foul air, damp dwellings, etc. Any discussion of health sub- 
jects can be but little more than the elaboration of these hackneyed 
expressions made interesting and impressive simply by the earnest- 
ness with which they are enforced. 

We announce no new discovery, only an open secret, when we say 
that the body and mind are in the most favorable condition for the 
maintenance of health when occupied by some congenial employ- 
ment. Work is not unhealthy. Many of the hardest workers the 
world has ever known have lived beyond their allotted threescore 
years and ten; and it would be a great misfortune for the masses to 
be relieved of the necessity of toil. The diligent live longer and 
enjoy more than the indolent whose time is a burden and who squan- 
der it in nursing imaginary evils and complaints. Idleness is destruc- 
tive of human happiness and the welfare of both individuals and 
nations. It tends to effeminacy and immorality. 

There is not so much danger of over work as is popularly sup- 
posed; but there is far greater danger of violating those general 
health principles to which reference has already been made. The 
(Treat danger is not from hard work but from worrv, anxiety and 
constant vexation, which are largely the outcome of our present 
methods of business in which competition is often so selfish, fierce 
and heartless. It is no wonder that in this desperate struggle many 
are crowded to the edge of the precipice and that occasionally some 
poor disheartened victim, prodded till his brain whirls and reason 

gives way, is tempted to leap off. These unnatural burdens of anxi- 
ety make the heaviest draft upon the reserve, exhaust the brain ami 
ire detrimental to health and bloom. 

Self regulation la one of those fundamental principles which if 



THE NEW MEDICAL WORLD. 49 

learned by experience may come too late. It is necessary to avoid 
that stress of business which interferes with digestion and refreshing 
sleep. There are many who do not allow sufficient time for eating ; 
"five minutes for refreshments," then the rush and scramble are 
renewed. We must not permit ourselves to get into a chronic state 
of hurry and fty around as if there was only another moment to live. 
Take time to eat, masticate your, food thoroughly; for this is the only 
process by which it can be prepared for digestion and otherwise you 
will pay the penalty, which is dyspepsia. 

Take time to sleep. It has been learned that eight or nine hours 
out of the twenty-four are essential for this purpose. Sleep is a period 
of recuperation during which repairs are in progress. Unless com- 
pensation is made during sleep for the wastes of the body an equilib- 
rium of its forces cannot be maintained. 

History appears to coincide with experience and proves that man 
needs, in addition to sleep, an occasional day of rest from his labors 
and there is probably no better arrangement than the one which 
already exists, of one day out of every seven. 

It is important to cultivate a cheerful disposition and not allow 
despondency to obtain control of the spirits. Cheerfulness quickens 
the circulation, adds warmth and vitality to the blood, sends a thrill 
of health to every fiber of the body and stimulates all the functions 
of animal life. Whatever banishes cheerfulness upsets the digestion, 
obstructs nutrition, makes the liver sluggish, renders the blood 
impure and riles up all the foundations of life. Cheerfulness 
purchases contentment, that perpetual feast for the mind, while its 
violation breeds discontent and may eventually end in suicide or 
insanity. 

There is no doubt but what great emotions overtax the nerve 
force, disturb the stomach, the brain, the heart, and should be 
avoided. There can be no emotion that does not reach the heart 
and brain. You cannot even run or hurry without compelling the 
heart to beat faster in order to provide the necessary force. There 
is nothing in the line of emotion or effort which does not affect 
the heart and consequently no organ is so liable to overwork. When 
the heart is overburdened and begins to fail the stomach becomes 
feeble, digestion is disturbed; the brain suffers from want of nutrition, 
the memory falters and unmistakable signs of age or exhaustion 
quickly follow. 

It has been observed that strong emotions affect unfavorably the 



.",!) THE NEW MEDICAL WoKLD. 

secretion of the mother's milk and it is a matter of record that adults 
have sometimes fallen dead in a fit of anger. How important it is 

then to regulate the emotions, to control the feelings and pracl 
Belf-management. 

Excesses of all kinds squander the vital forces, hence are debilitat- 
ing. They destroy the natural and normal equilibrium of the body 
and ought to be strenuously avoided. The control of self demands 
thai reason have sway even if it makes you a tyrant over your pas- 
sions. When reason presides there will be contentment, order, so- 
briety and happiness ; where reason is violated discontent, misery, 
intemperance and anxiety reign. Be on the outlook in regard to 
oxer-indulgence at the table and late suppers. In some things absti- 
nence, in others moderation and in all things a life pure and constant, 
is consistent with longevity. 

Temperance and sobriety are among the open secrets of a long 
life. The most natural drink for mankind is water and there is no 
more healthy beverage when all other things are considered. The 
prolonged use of alcoholic stimulants inflames the stomach, congests 
the brain, excites and overworks the heart, produces vascular excite- 
ment of all the organs and at length leads to alteration of their 
structure. 

All powerful or narcotic drugs should be avoided except under 
skilled direction for the amelioration or cure of disease. Those who 
resort on every trifling pretext to the use of such agents, unless 
restrained, will shorten life and till its brief remnant with untold bit- 
terness. 

All fatigue should be counteracted by rest or sleep and not by 
a resort to stimulants. When temporarily wearied a warm bath will 
be found refreshing; to the bath may be added with bene- 
fit a tablespoonful of aqua ammonia or a little common salt. 
Friction of the skin with a coarse towel should follow the bath; if 
this is thoroughly done it will draw away surplus blood from the 
overtaxed brain, equalize the circulation, invigorate the system and 
promote test. 

Harmless recreation, without making pleasure the aim in life, 
should be sought, for it is exhilarating. Change of place and rest 
from the drudgery of a continued and harassing occupation is 
refreshing. It is beneficial to body and mind to breathe the sefl 
air, to look upon the vast ocean, for the sight is both grand and 
inspiring. 



THE NEW MEDICAL WORLD. 51 

Travel is beneficial in many ways. It enables one to mingle with 
diverse classes of people, observe their habits, their hardships, their 
undesirable methods of living and teaches lessons of gratitude and 
contentment. Such experiences broaden and quicken the mind, 
increase its capacity for enjoyment and bring us into touch with all 
the world outside ourselves; they help us to avoid excessive thirst for 
wealth and assist us in the cultivation of charity, liberality, magnanim- 
ity. They illustrate the folly of the miser's stinginess, the unfriend- 
liness of the selfish, the emptiness of pride and enforce more just 
and correct views of life. 

Finally it should be borne in mind that there are more desirable 
attainments than old age with its infirmities, its waning strength and 
weakened intellect. Many have succeeded in crowding a short life 
full of glorious achievements. 



" We should count time by heart throbs. He most lives 
Who thinks most, feels the noblest, acts the best." 



CHAPTER III. 

GENERAL TOPICS OF INTEREST IN 

MEDICINE. 



I. Home Prescribing. — IT. Strange Delusions. — III. Patkxt 
Medicines. — IV. Medicines. — V. Doses. — VI. House- 
hold Remedies. 



I.— HOME PRESCRIBING. 

IF you can diagnose disease and determine from the symptoms 
what particular disease you have to treat and not confuse one 
disease with another, then the matter of prescribing for the members 
of your family will be quite a simple matter in ordinary cases. But 
if on the other hand you are unable to distinguish between things 
that differ and cannot recognize even the simpler forms of disease, 
you will be able safely to do but very little home prescribing. You 
cannot prescribe unless you will learn to read and interpret svmp- 
toms. This book will help you in this matter if you will give to its 
pages your earnest attention. 

The trouble with home prescribing is apt to be that you consider 
the patient dangerously ill when the ailment is simple, almost trifling: 
and then your imagination helps to exaggerate the ease, you allow 
your good judgment to be dethroned by fear, you first get nervous, 
then frightened and the whole household becomes demoralized. The 
reverse is still more unfortunate; for perhaps the disease is really 
serious, but being unable to interpret the symptoms you consider it 
slight and unimportant; time is lost and evil consequences are 
averted with difficulty. Every physician encounters cases where the 
household is misled in these different ways. The author has often 
been called to attend children sick with lung fever (pneumonia), 
some of them in great danger. It is quite usual to find some neigh- 
bor present whose reputation i^ extensive for experience ir sickness 



THE NEW MEDICAL WORLD. 53 

perhaps some old lady, wise in her own estimation, who with a know- 
ing look and j^ositive utterance hastens to display her cunning by 
remarking that "nothing but worms ails that child," and she usually 
feels quite humiliated when the doctor fails to confirm her diagnosis. 
There is no disease among children which deceives the household 
more often than pneumonia ; in another place you will find a full 
description of the symptoms. These can be easily learned if you 
will give heed, but if you cannot or will not learn these positive symp- 
toms then you will be obliged to depend upon some one whose 
knowledge is not guesswork. Above all, do not trust to some wise- 
acre who will declare every ill of childhood due to worms. 

There are many mild diseases which can be intelligently treated if 
you will only give heed to their symptoms and learn their simple 
management; there are other diseases you could not treat after a 
thorough medical education unless you had supplemented it with 
years of observation and experience. 

Diseases too difficult for home treatment will be outlined and the 
hint properly given, so that having recognized a serious malady you 
will see the need of experienced counsel and direction. It is far bet- 
ter to employ a skillful physician and pay him cheerfully than to run 
a serious risk and imperil the life of yourself or others for lack of 
knowledge. 

It is expensive to employ skillful counsel, but that is little com- 
pared with the heartache which would fill your life with a never- 
ending regret, if a dear friend or child were the victim of your igno- 
rance or prejudice. 

II.— STRANGE DELUSIONS. 

Many persons otherwise intelligent adopt a strange course when sick- 
ness overtakes them. As drowning men catch at straws so sick 
people are often the victims of lying pretenders. The belief that 
the gift of healing is a natural one is a relic of the past. In olden 
times disease was a demon, to be cast out by those who were espe- 
cially gifted in prayer and in other mysteries which the common peo- 
ple did not understand. Superstition and pretence come nowhere to 
the front at the present day, so much as in attempts to deceive and 
work the miracles of healing. Some people seem to be ever courting 
deception, ready for the silvery words of flattery and pretence. A 
good and competent man must live a long time in a community and 



.".4 



THE NEW MEDICAL WdlM.H. 



win the confidence of the people little by little, but let Borne 
brazen-faced deceiver come to town with flowing locks and advertise 
himself as the most wonderful healer of modern times, and it is 
astonishing how credulous the people are and how cheerfully they 
will bring forth their hidden shekels and how enthusiastic they will 
become over the Greasy locks and swarthy complexion of such an 
ignorant fraud. Men of honor and attainment stand a poor show in 
comparison with the boasting seventh son of a seventh son, a natural 
healer or perchance a natural bone-setter. 

Does a person know any too much about the practice of medicine 
who has made it a thorough and conscientious study, and who has 
pursued a complete course of medical study in a college of recognized 
merit ? Ask the opinion, if in doubt, of men of good judgment and 
experience who are leaders in their profession, if it is possible for a 
man to be a natural healer of diseases or a natural bone-setter or 
Burgeon. You would not employ a man to build a house because 
his only qualification was that he professed to be a natural carpenter. 
Y*ou would not think of employing a man to shoe a valuable horse 
because he pretended to be a born blacksmith. No man would pre- 
tend to be a natural carpenter or blacksmith because his works would 
condemn him and prove him a humbug. But there is something 
mysterious about the art of healing, nature is so prompt and efficient 
in her work, that a humbug or fraud can point to her incomparable 
art and shout, "Behold my skill, I can work miracles." People often 
employ these frauds who have almost no qualifications to treat them, 
because they boast unceasingly of some special and peculiar or inher- 
ited power oxer disease, without making any effort to ascertain 
whether they can perform a tithe of what they pretend. The fol- 
lowing code is a good one to remember: 

True wisdom is always quiet, modest and unassuming, makes no 
boast, is cautious about promising a cure for disease and free from 
pretence. 

Those who know nothing fear nothing, [gnorance i- loud- 
mouthed, shouting to attract attention, full of boa-ting and pretence 
and rushes into print to make impossible statement-. The pretender 

in medicine always heralds his coming with no little splurge, ljc hes- 

itates not to boast of marvelous ami impossible achievements. He 
can always cure consumption or Blight's disease in their last Btaj 

anything, no matter what. The truth probably is that his medical 
knowledge is bo scanty, that he knows almost nothing except a 



THE NEW MEDICAL WORLD. 55 

little smattering gleaned from the medical almanacs; his medicines 
are receipts that he has copied or stolen or obtained in questionable 
ways, yet what miracles they will perform, warranted to cure every 
disease flesh is heir to. What a shame it is that in some of the states the 
tramp, the jail-bird, the cowboy, any ignorant pretender, male or 
female, can enter a community and announce himself as Doctor 
Blank without fulfilling a single requirement as to medical study or 
graduation . 

The pharmacist must be registered, else he cannot put up your medi- 
cines; the dentist must be licensed, else he can neither fill nor extract 
your teeth ; the peddler who sells tin must have a license and even the 
man who picks rags from the gutter. But in some of the states no 
restriction is deemed necessary to protect citizens from self-styled 
doctors. A diamond in his shirt front, a dashing manner and a 
loud mouth are all some people demand as evidence of ability. 

III.— PATENT MEDICINES. 

"Canst thou not minister to a mind diseased?" 

Patent medicines like advertising doctors should be avoided. If 
you are in health you do not need them and if you are sick you need 
something better. A few of these shop remedies may possess a small 
amount of virtue, and even when taken at random may occasionally 
benefit, especially if the taker has a large degree of faith in their 
potency. It is usually the mysterious make-up of these compounds, 
coupled with the wondrous stories of the advertisement which ex- 
cites the curiosity of the credulous. If they could only see the form- 
ula written out in full upon the bottle and know how small the 
grain of truth the advertisement contains the spell would be broken 
and their faith shattered. 

The inspiration of all this vast business is not, as pretended, to 
alleviate human suffering and cure the ills of mankind ; for it is a 
money-making scheme. Vast fortunes have been made out of the sell- 
ing of mixtures for one dollar which cost about ten cents. Patent 
medicines are usually concocted out of inexpensive drugs and many 
of them contain an objectionable amount of alcohol and vile whiskey. 
Their great item of cost is not in the making of them but in adver- 
tising them. It is easy to see why the press rarely criticises with 
severity this nefarious business of selling nothing for something, 
inasmuch as about fifty per cent, of the income of advertising doc- 



56 THE NEW MEDICAL WORLD. 

tors and their remedies is paid to the newspapers. It is a matter 
simply of millions to the income of the press, and hence, no pub- 
lic sentiment is awakened and no attempt is made to instruct the 
people in regard to these important health matter-. 

The field for this patent medicine business is an extensive one, for 
the American people are largely overworked and nervous. In this 
condition they easily fancy themselves ill, and if they can be in- 
duced to read and ponder the worthless literature of the medical 
advertising page, this fancy will soon take a deep root and become 
an actual growing reality. More than half the dosing of the people 
is for fancied illness. If the mixtures they buy and prescribe 
for themselves were only as harmless as they are worthless little 
would need to be said. 

Even when you are really sick it is not much medicine you need. 
but a little, and that of the right kind. Do not pervert your stom- 
ach with base and uncertain mixtures; for it was never intended to 
be converted into an apothecary's shop. 

There are strong reasons for believing that patent medicines do a 
great amount of harm in the aggregate. They are often the cause 
of dyspepsia, constipation and a host of other functional disorders. 
Many people exercise about the same grade of intelligence in regard 
to medicine, as a certain family who called one doctor to see their 
sick child, and after his departure called still another doctor. Acting 
on the theory that if one doctor knows a little, two know more, they 
alternated one's medicine with the other's. Acting also on the the- 
ory that if one spoonful of medicine is good, two are better, they 
doubled each dose. As a result the child died. 

The following recent incident illustrates the danger of the patent 
medicine business: A hard-working butcher who inherited a taste 
for alcoholic liquors moved from the city to a small town to avoid 
temptation. In this village to which he had come was a certain gro- 
ceryman who had decided to sell out his stock of goods, and in order 
to do so offered them at reduced prices. The butcher bought a list 

of necessary goods and at the suggestion of the grocer, added to his 

purchase one of the compound sarsaparillas. He took his go. ids 
borne and soon commenced taking a dose of his Barsaparilla each 

morning, as he was obliged to go to work early and work a long 
time before breakfast. He soon noticed QOW6V6I that if he failed to 

take the medicine for a single morning he felt depressed and unequal 
t<> the work to which he had been accustomed. His next Btep was to 



THE NEW MEDICAL WOULD. n< 



resort to whiskey drinking for which the medicine had prepared the 
way. There is no question but what patent medicines under the 
names of bitters, tonics, etc., have often led the way to the dramshop, 
hence on this ground, if no other, they should be avoided. 



IV.— MEDICINES. 

Medicines are substances used to accomplish certain objects, as the 
prevention or cure of disease. They also help to produce changes 
in the body or in some tissue or part and bring about results more or 
less definite. 

Medicines possess certain properties which aid in their identifica- 
tion as color, taste, odor and weight. 

They also possess chemical properties some of which are similar 
and some are antagonistic or incompatible. Advantage is taken of 
the various properties of medicines by the prescriber. He sometimes 
unites remedies which aid each other and gets much better results 
than could be obtained by a single remedy. In order to do this suc- 
cessfully he must have an acquaintance with their chemical proper- 
ties, otherwise medicines might be placed in combination which 
would render the mixture worthless or even dangerous. Acids are 
neutralized by alkalies, and a knowledge of this fact enables one 
sometimes to relieve suffering or save life. A single medicine 
sometimes contains several active principles or medical proper- 
ties. 

The action of medicine often depends upon the size of the dose. 
Ipecac, in large doses, excites the mucous and muscular coats of the 
stomach and causes vomiting ; while in very small doses it may 
be successfully used to allay vomiting. It has other properties which 
render it valuable as an expectorant, an astringent and to check 
hemorrhage. Rhubarb has a double action, in the first place as a 
cathartic, in the second as an astringent. Opium is made more effi- 
cient for relieving pain by combining it with belladonna, while the 
action of the two remedies upon the pupil of the eye is antagonistic, 
the one contracting and the other dilating it. A great number of sim- 
ilar illustrations might be brought forward to prove that medicines 
are capable of accomplishing a great variety of results, if their prop- 
erties are familiar, and when they are administered in the correct dose 
and proper combination. 



. 



THE NEW MEDICAL WORLD. 



The insolubility of certain remedies must not be overlooked. 
Many are freely soluble in water, others in glycerine, others in acids, 
others in alcohol, still others in ether and some are not soluble in 
any of the substances mentioned. In order to prepare suitable com- 
binations it is necessary to know about the chemical properties and 
solubility of medicines, as this cannot be learned except by extensive 
study of chemistry and other branches, it has been deemed essential 
to include under the treatment of diseases, suitable prescriptions with 
complete directions for their use, in addition to the list and doses of 
household remedies in this chapter. Such an arrangement renders 
this work as complete as possible for the household purposes for 
which it is designed. 

Some medicines enter the blood and assist in removing from it 
morbid material, or add to it some property of which it is deficient; 
thus the quality of the vital fluid is improved, purified or enriched 
and made efficient to work a renovation of the system. In this way 
disease is cast out, normal processes are invigorated and health is 
restored. Such medicines are known as hcematics. 

Another class act upon the nervous system and exert their influ- 
ence upon some special nerve or nerve center, or upon all the nerve 
centers and the numerous nerve fibers by which they are connected. 
Medicines which work changes in the blood accomplish their mission 
in a deliberate and permanent manner, but those which influence the 
nervous system work quickly and the effect is often temporary and 
fleeting, requiring a repetition at stated intervals to continue the 
result. Such medicines are known as neurotics. 

Another class act upon the muscular system and cause contraction 
of the muscular fibres and are often used for allaying hemorrhage, or 
for toning up the system weakened by debilitating discharges: and 
they also diminish the secretions of the glandular system. These are 
known as astringi tits. 

Another class excite the secretions by stimulating the action of the 
glandular system. They aid in removing those morbid products 
which OUght to be cast out of the body. They are known as </////- 
iiuitivi 8. 

These classes are again divided and subdivided. It is necessary to 
consider later on some of these subdivisions in order to learn more 
about the action of various remedies. 

Medicines are introduced into the system in several ways, the 

mosl common of which is hy the mouth and stomach. Medicines 



THK NEW MEDICAL WORLD. 59 

introduced into the stomach are acted upon, absorbed and enter into 
the circulation just in the same way as food, after it undergoes solu- 
tion and digestion. 

Some medicines, like some foods, are not soluble in the stomach 
but only in the small intestines. The quickest and most positive 
action of certain medicines is obtained by injection into the cellular 
tissue under the skin. This is the modern and well-known hypo- 
dermic method. The injected medicine must be in solution so that 
it can be quickly taken up by the absorbent vessels which are numerous 
in this vicinity. This method is scarcely suitable for household prac- 
tice as only a few of the most powerful remedies are so used, and 
usually by physicians in cases of emergency where there is intense 
suffering and speedy relief is essential. Only about half the dose is 
required when medicine is introduced by this method. The needle 
of the syringe must be cleansed each time, before and after use, 
to avoid inserting any septic material which would result in a painful 
swelling or abscess. The hypodermic method has certain advantages. 

When medicine is administered by the mouth it may offend a sen- 
sitive stomach and vomiting may ensue ; or it may pass through the 
alimentary canal without being absorbed. Medicine injected under 
the skin exerts its full force, for it cannot be rejected nor expelled 
from the system without being absorbed. 

In some cases such remedies as liniments, lotions and ointments 
are advantageously applied to the integument. When it is necessary 
to treat a burn, a wound, parasitic affections and certain other dis- 
eases of the skin or to cause the destruction of some superficial 
growth, as a wart, medicines can be applied locally with success. 
There is considerable virtue in the well-known and much-used mus- 
tard poultice, when applied to relieve inflammation and pain in some 
neighboring part. Medicines applied externally, except to denuded 
surfaces, can be much stronger than those taken internally. 

The application of medicine to a surface, blistered for the purpose, 
is not of sufficient importance to receive detailed notice, and is 
rarely employed except in some case of emergency and would be of 
doubtful utility. 

Medicines are applied successfully to the mucous membrane of the 
eye, nose, throat and various other mucous surfaces. Diseases of the 
air passages are often benefited by the inhalation of medicated vapors 
sprayed by an atomizer. This method yields excellent results in 
catarrh, bronchitis and other inflamed conditions. 



60 THE NEW MEDICAL WO ELD. 

Medicines arc osed advantageously in enemas or suppositories. 
This is an efficient method of treating diarrbxBa, dysentery and 
various other diseases of the bowels, bladder and other pelvic organs. 
When the stomach is inflamed or too irritable to retain medicines or 

even nutrients, they are often introduced into the rectum, for a time, 
and the result is sometimes quite satisfactory. The indications for 
these special methods are noticed under the affections which indicate 
their use and need not be repeated here. 

There are a great variety of circumstances and conditions which 
modify the action of medicines and these must be kept in mind. 
The medicine suitable for an adult is often unsuitable for a 
child. 

Habit diminishes the susceptibility to certain remedies ; for instance. 
the opium taker uses a quantity with impunity often sufficient to 
destroy the life of a person not addicted to its use.' 

Children are easily impressed with the action of an emetic or 
cathartic. Opiates should rarely be given to children and then 
with the utmost care or under the direction of a competent phy- 
sician. 

Blisters should be employed, if at all, with great care in the case of 
children or delicate persons. The nervous system is especially sensi- 
tive in many such patients as well as the integument. 

Climate modifies the action of medicines considerably. It is found 
that remedies and doses used in one part of the world often produce 

unsatisfactory results in other parts, owing to the modifying influence 

of heat and cold upon the nervous system. 

The condition of pregnancy is one which should receive careful 
consideration when medicines are required, as much injury might be 
done by the administration of powerful or unsuitable agents. Med- 
icine should be given to a nursing mother with unusual care, as 
enough of a powerful narcotic might be absorbed and become an 
ingredient of the milk to injure the child. The medicine suit- 
able for one stage of a disease i> often unsuitable for another 
stage. 

There are many individual peculiarities which must be regarded. 
Some persons are always harmed by certain medicines which prove 
tor other people ordinarily beneflcial. Some conditions increase 
while other conditions diminish the action of medicines. To appre- 
ciate ;ill these modifying influences if will be necessary to give ear- 
nest attention to this part n\' the work. 



THE NEW MEDICAL WORLD. 61 



EMETICS. 



Emetics. — There are many medicines which excite nausea and vom- 
iting. They are often indicated to rid the stomach of poisons, to re- 
move some obstruction in the trachea or oesophagus, to expel secretions 
from the air passages, to relieve convulsions in children or headache 
and hysteria in adults. 

When an active poison has been swallowed death may result before 
a physician could arrive, or so much poison may have been absorbed 
into the system that his efforts would be unavailing. It is well to 
have some efficient remedies at hand to produce vomiting. A tea- 
spoonful of ground mustard and the same amount of common salt 
mixed up in a cup of lukewarm water, will usually act promptly and 
is harmless 

Ipecac is a harmless emetic but is rather slow in action. It is a 
good remedy, especially for children, when vomiting is indicated in 
bronchial diseases, to relieve the air passages. It is useful in croup 
and whooping cough. It is much used in small doses in colds and 
coughs, in bronchitis and other diseases of the air passages, for its 
expectorant effect. The emetic dose for a child is one teaspoonful 
or more of the syrup. 

The compound syrup of squill (Hive Syrup) may be used to pro- 
duce vomiting. It owes its chief action to the small amount of tar- 
tar emetic which it contains, each teaspoonful containing one-eighth 
of a grain. The dose for a child is from eight drops to a teaspoonful. 
It produces considerable nausea and is consequently quite depressing. 
It should be administered to a feeble infant, if at all, with considerable 
care, in small and repeated doses. 

Alum in powder is an excellent remedy in croup to promote vom- 
iting. It has considerable reputation for dislodging the false mem- 
brane which is characteristic of this disease and in preventing it from 
reforming. It is prompt, thorough and without depressing effects. 
A teasjjoonful of the powder may be administered in syrup and 
repeated every half hour till it causes free vomiting. The action of 
emetics is favored by a free use of lukewarm water. 

Cathartics. — These are medicines which cause the bowels to act, 
usually by irritating their muscular fibers, thus stimulating the nor- 
mal peristaltic action. Cathartics are often serviceable but no rem- 
edies are more abused in domestic practice. The custom of buying 
cheap pills composed of aloes, gamboge and such like drugs cannot 



f)li THE NEW MEDICAL WORLD. 

bo too severely condemned. They cause an evacuation of the bow- 
els in consequence of their irritant action; but constant repetition 
renders their action less satisfactory and the bowels finally lose their 
normal vigor or tone and will not respond to the natural stimulus. 

In this way the habit of constipation is often induced and becomes 
chronic. It is always detrimental to the comfort and health of the 
individual. Constipation and its attendant evils and Bufferings are 
largely the result of the cheap and drastic pills bought in the shops ; for 
they produce an over stimulation of the bowels and reaction is sure 
to follow. They are called mandrake pills and liver pills to give them 
popularity and increase their sale. They often bring a large fortune to 
the proprietor,, Avho has little regard for the injury they cause. Sim- 
ple remedies to produce daily and normal evacuation of the bowels 
are preferable to harsh and irritating medicines. 

Regulation of the diet, the eating of fruits or the occasional injec- 
tion of water or soap water or a small dose of nux vomica daily, to 
improve the action of the muscular coat of the bowels, are simple 
remedies but much more satisfactory in the long run than harsh 
cathartics. 

Among medicines the granular effervescent citrate of magnesia is a 
mild though excellent cathartic. From a teaspoonful to a dessert- 
spoonful in a half glass of water can be taken each morning or 
of tener, as needed. 

The sulphate of magnesia (Epsom Salts) is an old and cheap rem- 
edy and in certain cases where there is a tendency to dropsical effu- 
sions it is especially valuable. It has been recently prepared in the 
granular effervescent form which adds not only to its cost but to 
its elegance. The dose of this is one or more tablespoonfuls in 
water. 

The infusion of senna is a safe ami valuable physic. It is liable to 
produce griping pains and hence should be combined with such car- 
minatives as ginger, peppermint or camphor. Its taste is rather un- 
pleasant. It is prepared like a cup of tea by pouring :i little boiling 
water upon a generous pinch of the leaves. 

Castor oil is a well-known domestic remedy, somewhat difficult to 
take but an excellent physic for many conditions. It is soothing in 
its nature, it does not produce nor aggravate inflammation and is Mire 

to act if given in sufficient doseand allowed a proper time. It may 
be given <>n the top of a cup of milk, coffee, chocolate or soda water 
or with lemon juice and be scarcely tasted. There is no better phvMc 



THE NEW MEDICAL WORLD. 63 

for children in summer nor for women after confinement. The dose 
for children is one to two teaspoonfuls ; adults can take one or two 
tablespoonfuls as needed. 

Of the many remedies used as cathartics reference will be made 
here to only one other, namely, podophyllin. This is a remedy of 
o-reat potency in curing constipation. It stimulates the liver to a 
healthy action, increases the now of bile and in small doses is one of 
our most valuable remedies. Its efficiency will be improved by com- 
bining it with mix vomica. It is usually taken in too large doses. 
It can be obtained in little sugar-coated parvules containing one- 
twentieth of a grain. From one to two of these may be given to a 
child as needed. If the parvules cannot be obtained it may be used 
in the following prescription: 

i * 

]^ Podophyllin six grains 

Alcohol one ounce 

Mix. Dose, six drops in sweetened water for a child one year old 
and for other children in proportion each day as needed. 

The following makes an excellent pill for general cathartic use : 

fy Podophyllin one grain 

Hydrastin ten grains 

Leptandrin five grains 

Ex. ^ux Vomica three grains 

Ex. Hyoscyamus five grains 

Mix. Make twenty pills. Dose, one each night or one each night 
and morning as needed. 

The dose in the above pills is small, the design is not to over- 
stimulate the action of the bowels but to bring about a natural and 
healthy condition when their use is to be diminished or discontinued. 

Diuretics. — Diuretics are medicines which increase the action of 
the kidneys and consequently augment the flow of urine. A very 
intimate relation exists between the skin and kidneys. In hot weather 
large quantities of fluid escape from the body through the pores of 
the skin, while in cold weather the kidneys are more active and 
secrete a larger quantity of urine. Diuretics are made use of not 
only to increase the flow of urine but also the solid constituents 



04 THE NEW MEDICAL WORLD. 

which it holds in solution. It is for this reason that diuretics are 
administered in gout; for they assist in carrying off the uric acid and 
the other waste products which clog uj> the system and produce dis- 
ease. They are much used to cany away the excess of fluids in drop- 
sical effusions. They are prescribed in rheumatism for the purpose 
of eliminating the lactic acid, which if retained in the blood in 
excess is thought by some to be a common cause of this disease. 
Diuretics are numerous and it will not be difficult to select a few 
suitable for domestic use. 

Some mineral waters, as the Bethesda, are given with excellent 
results as diuretics. 

An infusion of buchu or uva ursi leaves are serviceable diuretics 
and easily prepared as needed. The dose of the infusion is two or 
three tablespoonfuls. 

The following combination is much more efficient than one rem- 
edy alone : 

I£ Acetate of potash one ounce 

Ext. Buchu ff. one ounce 

Sweet spirits of nitre one-half ounce 

Syr. Tolu. two ounces 

Wintergreen water sufficient to make eight ounces. 

Mix. Dose, one or two dessertspoonfuls three times a day taken 
in water. 

The following is an efficient diuretic: 

Ijt Juniper berries two drams 

Cream of Tartar two drams 

Boiling water one-half pint 

Mix. Flavor with wintergreen and use as needed to increase the 

flow of urine. 

The granular effervescent citrate of potash is an excellent diuretic 
drink. Dose, a dessertspoonful in a glass of water and drink while 
effen esoing. 

In dropsical conditions, digitalis combined with caffeine are very 
efficient, but such remedies are not suitable for any but physicians to 

administer. 

Sudorifics. — These are medicines which stimulate the sweat 

glands and produce copious perspiration. The action ot sudorific 



THE NEW MEDICAL WORLD. 65 

remedies is retarded by cold and favored by warmth ; and when such 
remedies are administered they will be assisted to produce their best 
results by bathing the feet or body in hot water, drinking hot drinks, 
covering the patient with blankets and by the application of hot 
poultices and artificial heat. Sweating medicines are made use of 
in domestic practice to break up colds. They are beneficial in the 
early stage of fevers, measles, scarlatina, pneumonia, pleurisy and 
other affections of the lungs and throat; also in dropsical affections. 
Hot sage or catnip tea, hot drops, pepper or composition tea will 
often promote profuse sweating without resort to more positive rem- 
edies. 

Opium is a valuable remedy to produce perspiration. The dose is 
one grain. Still better than opium alone is its combination with 
ipecac in the familiar and widely-used Dover's powder, the adult 
dose of which is from five to ten grains. 

Aconite is much used in the early stage of fevers and is especially 
valuable to produce sweating in children. Ten drops of the tincture 
of aconite can be added to two-thirds of a tumbler of water, one tea- 
spoonful of which can be given every half hour or hour till it thor- 
oughly 'moistens the skin, when it may be continued at longer inter- 
vals as needed to allay fever. 

Jaborandi is a popular remedy with physicians but is hardly a 
household medicine. 

The tincture of lobelia may be given in doses to adults of from 
ten to sixty drops every hour or two and will be found efficient if not 
too depressing for the patient. 

The following is a good prescription in the early stage of pneu- 
monia or other acute diseases, to favor sweating : 

3 Tiq. ammonia acetate one ounce 

Tincture of aconite fifteen drops 

Syrup of ipecac two ounces 

Water sufficient to make four ounces 

Mix. Dose, one teaspoonful every two or four hours. 

The sweet spirits of nitre in doses of from one-half to one tea- 
spoonful is a valuable domestic remedy. 

Quinine in five to ten-grain doses lowers the temperature and pro- 
duces perspiration. If threatened with some acute disease, as pneu- 
monia or pleurisy, I should have more faith in this remedy to abort 



Ob THE NEW MEDICAL WORLD. 

it than in all the others. It would be necessary to make the dose 
large enough to produce a decided impression upon the system, and 
to take it in the first stage of the disease. 

Astringents. — These are medicinal substances which cause con- 
traction of the muscular fibers and soft tissues of the body. They 
have a puckering taste and coagulate albumen. They are used both 
internally and externally. 

There are two varieties of astringents, vegetable and mineral. The 
vegetable astringents owe their virtue to tannic or gallic acid. The 
mineral astringents as alum, sulphate of zinc and the sub-sulphate of 
iron are more styptic in their nature and the last is so powerful in its 
action that it not only contracts the tissues, but instantly coagulates 
the blood and can be used to arrest hemorrhages from the vessels of 
small caliber with considerable success. 

Astringent remedies are applied to the mucous membrane of the 
nose, throat, the eye, the bowels, the urethra, vagina and wherever 
there is inflammation, congestion and a relaxed or swollen condition of 
the mucous surfaces. 

Tea and coffee are somewhat astringent owing to the tannin that 
they contain. Persons not accustomed to their action will find the 
first use, especially of strong tea, attended with marked constipation. 

Ergot powerfully contracts unstriped muscular fibers and hence its 
ability to control hemorrhage by diminishing the caliber of the blood 
vessel. It will contract the uterus when it is in a relaxed eon iition. 
It has considerable power to relieve diarrhoea and hemorrhage of the 
bowels or lungs and also congestion of the brain. 

The sulphate of zinc is much used as an astringent in conjunctivi- 
tis, gonorrhoea and vaginitis. 

The subnitrate of bismuth is regarded as of great value in Bummer 
diarrhoea, especially in cholera infantum. 

Blackberry root is also a vegetable astringent which enjoys con- 
siderable reputation in diarrhoea. The infusion, fluid extract, syrup 
or wine, are all efficient. It may be prepared domestically and enough 
brandy added to the infusion to keep it. The brandy improves its 
medical action in weakened and relaxed conditions. 

Witch-hazel owes its popularity to its astringent action. It has 
some virtue iii the treatment of pile*, mild hemorrhages, varicose 

veins and ulcers and chronic throat atliections. 

Gallic acid is administered for internal hemorrhages. 



THE NEW MEDICAL WORLD. hi 

Nitrate of silver in suitable solutions is an astringent of great effi- 
ciency. In some eases of persistent diarrhoea, combined with opium, 
it has cured cases in the author's practice that have resisted every 
other method of treatment. It is not a domestic remedy. 

Tannin in some cases of painful hemorrhoids (piles) has been used 
in combination with cocaine and other remedies (in suppositories) 
with almost magical results. 

The list of astringents has only been touched upon here. They 
form a very large class of remedies; but those suggested are in 
common use and represent the whole class sufficiently for these pages. 

Astringents when taken internally should not be brought in con- 
tact with the stomach or food, just before eating or during the proc- 
ess of digestion, they should be taken in a pill or else well diluted. 

It may be noticed that some of the remedies mentioned, as the sul- 
phate of zinc and the sulphate of copper, act as emetics as well as 
astringents. Many other remedies possess properties which belong 
to two or more classes. 

Tonics. — Tonics are medicines which impart strength and energy 
to the system. They quicken the appetite, aid digestion, stimulate 
the various functions of the bodily organs, improve the quality and 
quantity of the blood and thus increase the strength and build up the 
general health. 

Tonics like other remedies have a wide range of action, some 
exerting their influence upon the blood, as iron, others upon the nerv- 
ous system as phosphorus and strychnia and others as the simple bit- 
ters upon the stomach. Tonics can be used but little in acute dis- 
eases or inflammatory conditions ; but for the most part they are 
appropriate in the debility which follows prolonged sickness and in 
chronic disorders. 

Tonics must be selected with reference to the particular condition 
:t is essential to reach and improve, but the dose must not be too 
laro-e as there is dangler of disarranging the digestion instead of 
strengthening it. 

Tonics designed to improve the apj)etite should be taken betore 
meals. Medicines designed to aid digestion, like pepsin, or to stimu- 
late the flow of gastric juice should be taken at meal time or directly 
after. The simple vegetable bitters which have the reputation of 
stimulating the appetite and improving digestion are represented by 
gentian, colombo, mix vomica, motherwort and boneset. 



68 THE NEW MEDICAL WORLD. 

There is no single tonic equal to iron in a large number of cases 
especially where anaemia is marked. It improves the blood, adds to 
its richness and renders it able to carry to the cells which are elab- 
orating the tissues, the materials which are essential to growth or 
health. The slow recovery which is liable to follow fevers, pneu- 
monia and other severe sicknesses is often hastened by iron in some 
suitable form or combination. 

Salicin is of marked benefit in cases suffering from chronic rheu- 
matism. 

Cod liver oil is sometimes indicated in wasting diseases and in 
scrofula. It enriches the blood and aids in the reproduction of tis- 
sues ; hence the body shows that it is better nourished during its use. 
It combines the virtues of a food and medicine. It contains bro- 
mine, iodine, phosphorous and iron in small quantities in addition to 
a large amount of nutrition. Its use has been so extensive that it 
has often been prescribed where it was neither indicated nor tolerated 
and in this way it has sometimes been brought into disrepute. Not- 
withstanding all this there are cases, especially of wasting diseases, 
where it serves an admirable purpose. 

The following is an elegant emulsion : 

I£ Gum Tragacanth two drams 

Cold water one pint 

Oil sweet almond sixteen minims 

Cod live oil one pint 

The directions for combination must be observed. Place the trag- 
acanth in the water and let it remain for twenty-four hours, stir occa- 
sionally, then place it on the back of the stove, warm it a little and 
sweeten to taste with sugar, then add one pint of pure cod liver oil 
and mix thoroughly, adding the oil of sweet almond. If preferred the 
oil of peppermint, wintergreen or lemon may be used instead to flavor. 

Wild cherry bark is a good tonic. It possesses sedative proper- 
ties making it popular in coughs. Quinine enjoys the distinction of 
being a tonic- almost specific in malarial troubles, it is also indicated 
in enlarged spleen of malarial origin. Other tonics possess proper- 
tics of a stimulating character and will be noticed under the head of 
stimulants. 

Antispasmodics. — These are remedies which allay the excited 
condition of the nervous system as seen when the muscles are thrown 



THE NEW MEDICAL WORLD. 69 

into a state of spasm or convulsion. They are very similar in their 
action to nervines. They quiet and soothe the nerves which are un- 
duly excited, relax the muscular condition and secure rest which is 
often the prelude to recovery. 

They are necessary in treating the convulsions of children, hys- 
teria, chorea, tetanus (lockjaw), and diseases of this class. Among 
the vegetable antispasmodics may be mentioned lobelia, camphor, 
valerian and assafoetida. Other remedies are ether, chloroform and 
chloral-hydrate. The latter remedy is elsewhere recommended for 
the convulsions of children and its method of use and administration 
will be found under that head. 

Assafoetida is an efficient remedy for hysteria. It is a safe medi- 
cine with disagreeable odor and taste and is usually prescribed in 
pills containing two or four grains. 

Stimulants. — Stimulants increase the heart force and are indi- 
cated in the condition known as shock. When a severe injury has 
produced a powerful and depressing effect upon the nervous system 
or where disease has been so prostrating as to cause a marked decline 
in the heart force and threaten failure in that vital organ, the condi- 
tion is similar to that known as shock and usually requires stimulants. 

Ammonia acts quickly in emergencies and in cases of fainting is 
often serviceable. Its inhalation is beneficial. It may be given inter- 
nally and in weak conditions it has been injected hypodermically. 

The carbonate of ammonia is a reliable stimulant of the lungs in 
pneumonia and other diseases where the lung capacity is greatly 
diminished. 

Alcoholic liquors are much used for their stimulating effect in 
cases of emergency and in some diseases which depress the vitality 
by the action of poison upon the nerve centers. 

Turpentine has considerable reputation as a diffusible stimulant, a 
carminative, a diuretic and anthelmintic. 

Digitalis stimulates the heart's action and in suitable cases is a rem- 
edy of decided value but it is in no sense a household remedy. 

Nitro-glycerine in doses of one one-hundredth of a grain exerts a 
powerful and almost instantaneous exhilaration of the heart's action. 
It can be obtained in tablets of the above dose. 

Sedatives.— These are medicines which lessen the heart's action 
as aconite, gelsemium, veratrum, tartar emetic and prussic acid. 



70 THE NEW MEDICAL WOULD. 

They arc dangerous remedies except in small and suitable doses, and 
poisons winch cannot be trilled with. In fevers and acute inflam- 
mations they afford the prescriber some of his most valuable 
weapons for combating disease. When the pulse is rapid, strong, full 
or bounding, no remedies are administered with greater satisfaction 
and with more certain results. In the early fever stages, in pleurisy 
and pneumonia, aconite and veratrum are remedies of efficiency. 

Aconite has come to be so widely known and so generally recog- 
nized and employed as a domestic remedy that it is necessary to know 
when and how to administer it. It produces the best results in small 
doses. It lessens the frequency of the pulse, calms the excitement of 
the heart, relieves the circulation, relaxes the skin and produces 
moisture in febrile conditions. 

Veratrum is given in the same dose as aconite and by some is con- 
sidered preferable in the early stages of pneumonia and other inflam- 
matory conditions. It should not be used if the heart is weak or if 
the condition shows signs of depression and exhaustion. It may be 
as successfully used as aconite or any other powerful remedy. Put 
ten drops of the fluid extract or fifteen of the tincture in half a glass 
of water and give one teaspoonful every hour till the pulse rate 
declines near the normal. 

The leaves and bark of the peach tree contain a trace of prussic 
acid and are consequently sedative. One or two tablespoonfuls of 
the infusion are said to be serviceable in irritable stomach, with nau- 
sea and vomiting. Dilute prussic acid in small doses is often added 
to cough mixtures for its sedative effect. 

Gelsemium is a valuable sedative to the nervous system. It allays 
congestion of the brain and is especially serviceable in meningitis and 
is reported to have cured cases of lockjaw. It is a valuable remedy 
in neuralgia of the face, the pains of menstruation, also the after 
pains following labor. It is serviceable in inflammation of the Lungs 
and has been highly recommended in bilious and malarial fevers. 

Expectorants. — Expectorants are remedies which act on the 
mucous membrane lining the throat and bronchi and modify the 
character and quantity of the secretions. They are sometimes use- 

ful in acute and chronic bronchitis, but they should DOt be t<»<» long 

continued. Some of the more common ami efficient expectorants are 

the syrup of tolu, syrup of ipecac, syrup of squill, sanguinaria. chloral 
hydrate and miniate of ammonia. 



THE NEW MEDICAL WORLD. 71 

Antipyretics. — Antipyretics are remedies which antagonize feb- 
rile conditions and lower the temperature. Acetanilide and phen- 
acetine are members of this class. The}^ may be safely given in five- 
grain doses if there are no signs of heart weakening. 

Alteratives. — Alteratives are medicines which affect the bodily 
nutrition, stimulate the secretions, aid elimination of waste products 
and cause improvement in the health. They are closely allied to 
tonics, stimulants and laxatives. An alterative remedy often pos- 
sesses the property of several other classes. 

Podophyllin acts favorably upon morbid conditions of the system, 
removing the effete materials and stimulating the secretions ; hence 
it is not only a cathartic but a powerful alterative. 

Yellow dock, burdock and bloodroot are among the most useful 
and efficient vegetable alteratives. 

The iodide of potash, lime and iron are often used with the most 
happy effect. The administration of such remedies cannot be recom- 
mended for domestic use except in some combination. The fol- 
lowing prescription is a reliable blood purifier and an efficient alter- 
ative. 

]J Iodide of potash two drams 

Ext. sanguinaria, fl. one dram 

Ext. yellow dock, fl. one ounce 

Syr. sarsaparilla comp. one ounce 

Spirits gaultheria two drams 

Elix. cinchona q. s. to make four ounces 

Mix. Dose, one teaspoonful three times a day after meals. This 
may be given where the condition of the system requires thorough 
renovation. 

Antiseptics. — Antiseptics are remedies which prevent putrefaction. 
Some of the more commonly used are chlorine, creosote, carbolic acid, 
salicylic acid, boracic acid and corrosive sublimate. 

Escharotics. — Escharotics are applied locally to destroy some 
growth or unhealthy tissue. They are the strong acids, especially 
nitric, nitrate of silver, caustic potash, chromic acid and carbolic 
acid. 



72 THE NBW MEDICAL WORLD. 

Anodynes. — These are used to relieve pain. At the head of the 
list stands opium and some of its alkaloids as morphia and codeina. 
Belladonna and its alkaloid atropia, especially where associated with 
opium or morphine, assist in relieving pain. Henbane and its alka- 
loid hyoscine are also included in this list. The alkaloid is given in 
d<»scs of one one-hundredth of a grain. Opium and its helpers ought 
not to be prescribed on every pretext of pain. Prescriptions con- 
taining them ought not to be repeated except by the advice and con- 
sent of the physician who first ordered them. Too little attention is 
given to the danger of the morphia habit. A resort to opium or 
morphine on every occasion is reprehensible; and yet at times their 
use is demanded and to withold such agents is unwise, but their use 
should be discontinued as soon as the condition of the patient will 
admit of it. In peritonitis there is no remedy which can take its 
place. It should be given in this fearful disease boldly and unspar- 
ingly till the danger is over. It has saved many lives. 

Properly used opium is one of the most valuable remedies known 
but it is not a remedy for domestic use, except perhaps in the form 
of paregoric, Dover's powder and Tully's powder. It requires much 
experience and skill to know when and how to use an agent so 
potent for good or for evil. 

Anodynes should be sparingly administered to children and 
only in minute doses as their nervous systems are powerfully 
impressed by this class of remedies. When a very sensitive 
stomach will not tolerate morphine from an eighth to a fourth 
of a grain inserted under the skin will produce speedy relief. 

Anaesthetics belong to this class. They are taken by inhalation 
and produce such a condition of unconsciousness that a tooth can be ex- 
tracted or a limb amputated without any feeling of pain whatever. 
Their discovery has accomplished much for the progress of surgery 
as well as for the amelioration of human suffering. 

Other minor classes of medicine as carminatives allay pain in the 
stomach and bowels from flatulency; anthelmintics destroy worms. 
These require mention merely as the remedies referred to are suffi- 
ciently mentioned in connection with the treatment of the various 
diseases in ..thcr sections of this work. 

Emmenagogues are remedies which favor the appearance of the 
monthly flow. 



THE NEAV MEDICAL WORLD. 73 

Aphrodisiacs are remedies which stimulate the sexual organs and 
their functions. 

Infusions are generally made by pouring boiling water upon medici- 
nal substances, whether bark, leaves, roots or seeds and allowing it to 
cool. Then it is strained. An infusion should be made in small 
quantity and fresh as wanted as it does not keep well. 

Tinctures are prepared by soaking the medicinal substances in 
officinal or dilute alcohol. The dilute alcohol dissolves medicinal 
principles, which water will not, and its preservative Qualities are a 
great advantage. 

Syrups are simply medicated fluids added to a sugar solution. 
Many of the medicated syrups are useful in the preparation of pre- 
scriptions, some adding more to their flavor than to their virtue. 

Some medicines are best given in powder form but when they are 
very bitter or bad tasting they are better in the form of a pill, tablet 
or capsule, so that they can be swallowed without tasting. The 
preparation of medicines has become an extensive business and 
requires an acquaintance with a great variety of processes. Anyone 
wishing to give the subject thorough study should consult the 
United States Dispensatory or other books on the subject of phar- 
macy. 

Many medicinal substances like opium, contain several distinct 
alkaloids or active principles. The separation of these active prin- 
ciples from drugs as strychnia from mix vomica, atropia from bella- 
donna, quinia from cinchona and morphia from opium provides the 
physician with a list of efficient medicines in concentrated form 
always reliable in dose and action. This is a great benefit both to 
the patient and physician. It does away with the administration of 
large draughts of nauseating mixtures as well as with the doctor's 
saddle-bags. In the ordinary pocketcase containing only one or two 
dozen little bottles, can be stored more medicinal virtue at the pres- 
ent day than could be placed in the oldtime attic filled with herbs, 
roots, plants and barks from meadow and woodland. 

The following abbreviations commonly used will be found com 
venient : 

aq. stands for the Latin aqua and means water 

carb. " " " • " carbonas " " carbonate 

co. or comp. " " " " compositus " " compound 
cort. " " " " cortex " " bark 



74 



THE NEW MEDICAL WORLD. 



(HI. 


stands 


for 


the 


Lati 


n dilutus : 


and 


means 


dilute 


(list. 


u 


u 


LL 


LL 


distillatus 


a 


LL 


distilled 


emp. 


LL 


u 


LL 


LL 


emplastrum 


LL 


LL 


plaster 


ext. 


u 


ll 


LL 


LL 


extractum 


LL 


LL 


extract 


fort. 


a 


ll 


LL 


LL 


fortior 


LL 


LL 


stronger 


inf. 


a 


ll 


LL 


LL 


infnsum 


((• 


LL 


infusion 


lin. 


u 


ll 


LL 


LL 


linimentum 


LL 


LL 


liniment 


lot. 


a 


ll 


LL 


LL 


lotio 


LL 


LL 


wash 


mist. 


a 


ll 


LL 


LL 


mistura 


LL 


LL 


mixture 


mur. 


a 


LL 


LL 


LL 


mnrias 


LL 


LL 


muriate 


nit. 


a 


LL 


LL 


LL 


nitras 


LL 


LL 


nitrate 


ol. 


a 


LL 


LL 


LL 


oleum 


LL 


LL 


oil 


pul. 


u 


LL 


LL 


LL 


pnlvis 


LL 


LL 


powder 


rad. 


ll 


LL 


LL 


LL 


radix 


LL 


LL 


root 


sol. 


a 


LL 


LL 


LL 


solutio 


LL 


LL 


solution 


spts. 


a 


LL 


LL 


LL 


spiritus 


LL 


LL 


spirits 


snlph. 


a 


LL 


LL 


LL 


sulphas 


LL 


LL 


sulphate 


snppos. 


a 


LL 


LL 


LL 


suppositorium 


LL 


LL 


suppository 


SVT. 


a 


LL 


LL 


LL 


syrapus 


LL 


LL 


syrup 


tr. or tine. 


« 


LL 


LL 


LL 


tinctura 


LL 


LL 


tincture 


ungt. 


(( 


LL 


LL 


LL 


unguentum 


LL 


LL 


ointment 


vin. 


u 


LL 


LL 


LL 


vinum 


LL 


LL 


wine 



The following are the more common abbreviations used in pre- 
scriptions : 

stands for the Greek ana and means of each 



a a 



ad 


LL 


LL 


LL 


Latin 


adde 


LL 


LL 


add 


chart 


LL 


LL 


LL 


LL 


chartula 


LL 


LL 


a small paper 


collyr. 


LL 


LL 


LL 


LL 


collyrium 


LL 


LL 


eve water 


1). ' 


LL 


LL 


LL 


Greek 


dosis 


LL 


LL 


dose 


div. 


LL 


LL 


LL 


Latin 


divide 


LL 


LL 


divide 


fl. 


LL 


LL 


LL 


LL 


fluidum 


LL 


LL 


fluid 


ft 


LL 


LL 


LL 


LL 


fiat 


LL 


LL 


make 


M. 


LL 


LL 


LL 


LL 


misce 


LL 


LL 


mix 


pil. 


LL 


LL 


LL 


LL 


pilula 


LL 


LL 


pill 


q. s. 


LL 


It 


u 


LL 


quantum 


suth( 


•it u 


sufficient quantity 


Big. 


LL 


LL 


LL 


It 


signa 


and 


LL 


write 


ss 


LL 


LL 


It 


u 


semis 


LL 


LL 


one-half 


t. i. d. 


LL 


(( 


u 


l< 


ter in diem" 


LL 


three times a day 


gr. 


LL 


hi 


(( 


" 


granum 


LL 


(( 


a grain 



minimum " 


cc 


a minim 


scrupulum " 


cc 


a scruple 


drachma " 


cc 


a dram 


uncia " 


cc 


an ounce 


octarius " 


a 


a pint 



THE NEW MEDICAL WORLD. 75 

gtt. stands for the Latin gutta and means a drop 

jq cc cc cc c< 

-p. a a cc (i 

T cc cc a (i 

Z « « " ' 

Q a u cc c< 

P} This sign is placed at the head and left hand of each prescrip- 
tion and means recipe or take, the remedies to be taken or used 
usually follow in Latin, taking the genitive termination, while the 
quantity if written out would take the accusative case. In practice a 
prescription is never fully written out; it is abbreviated and the 
directions are written in plain English. For the sake of ease in 
reading it has seemed best to discard in this work the use of Latin 
and symbols for the most part and use English words. 

one minim is equivalent to about two drops 



one dram " 




cc 


one 


teaspoonful 








two drams " 




cc 


one 


dessertspoonful 






four drams " 




cc 


one 


tablespoonful 








sixty minims 






make 


one 


) dram wi 


•itten thus : 


3f 


eight fluid drams 






a 


cc 


ounce 


cc 


cc 


oT 


sixteen fluid ounces 






cc 


a 


pint 


cc 


cc 


Or 


twenty grains 






cc 


cc 


scruple 


cc 


cc 


3r 


three scruples 






cc 


cc 


dram 


cc 


cc 


3i- 


eight drams 






cc 


cc 


ounce 


cc 


cc 


3i~ 


sixty grains 






cc 


cc 


dram 


cc 


cc 


3r 


four hundred and ei 


ghty 


grains 


cc 


cc 


ounce 


cc 


cc 


3t 



A little time and study devoted to the above symbols will render 
them plain and well repay one interested in medical literature for 
the labor. 

Y. DOSES. 

The dose of any medicine is the average quantit} 7 , ascertained by 
experience as necessary to produce a desired result. No more of any 
medicine should be administered than the necessity of the case re- 
quires, nor should its use be needlessly prolonged. 

A powerful, dangerous remedy should not be chosen when a mild 
and harmless one will answer* just as well. 

Any remedy should be avoided which is liable to produce results 
more desperate than the condition for which it is to be administered. 



70 THE NEW MEDICAL WORLD. 

Age is an important factor in regulating the dose of medicines. 
The chief difficulty in household prescribing is to determine the 
proper dose for the different ages. How much ought to be given to 

an infant or a child one or two years old ? In administering medicines, 
the dose for an adult is taken as the standard, and when a dose m 
recommended, unless otherwise specified, an adult dose is always to 

l»e understood: The following will he helpful in ascertaining the 
dose for different ages : 

An infant from one to three months old requires about ^ the 

adult dose, six months old -fa. 

Give a child one year old ^ of the adult dose. 

" " two years " 1 " " 

" " three " " i " " 

t< u four " u V u " '* 

t( t< ayv U U 1 U t( U 

u u twelve " " l 

" a person fourteen " " | " " M 

u " from eighteen to twenty nearly the full dose. 

After fifty reduce the dose J 
" seventy " " i 

" ninety " " \ 

There arc sonic exceptions to the above rules which should be 
borne in mind. Persons under size require a smaller dose than those 
over weight; those in a debilitated or feeble condition require a 
smaller dose than the robust and strong. Persons engaged in in- 
door work, or those of sedentary habits require a smaller dose than 
those engaged in manual Labor, ami who are exposed to the weather 
at all seasons. 

.Medicines should he prescribed tor feeble infants ami very old peo- 
ple with especial care. The nervous system of an infant is easily 
impressed, therefore opium or morphine, if given to very young 

children, should be in smaller doses than those indicated by the fore- 
going rules, ami such remedies ought not to he prescribed by inex- 
perienced persons. 

< >\\ ing to the sensitive condition of the mucous membrane in young 
children, emetics and cathartics act with proportionably greater 
energy than in tin- case of adults, so that the administration of such 
remedies should be cautious and guarded ; and the harsh and more 
irritating remedies should consequently he avoided. For domestic 



THE NEW MEDICAL "WOULD. 



77 



use choose those remedies which are simple and whose effects are 
well known. Many harmless medicines are the most efficient, and it 
is not necessary to be as particular in their administration. They 
can be given in much larger doses to children than indicated by the 
above rule. It is not necessary that a remedy should be expensive 
in order to be efficient. In using a remedy with which you are but 
little acquainted, choose the minimum dose ; this rule is imperative 
in the case of energetic and powerful drugs. 

Small doses, frequently repeated generally give better results than 
laro-e doses at longer intervals, except where vomiting is the object 
aimed at. 

A dose table for the more common remedies, and the diseases for 
which they are chiefly used, is here appended, while valuable medical 
combinations with full directions for their use, is to be found under 
the treatment of each disease. 

In addition to the following doses those remedies advised for 
household practice will each receive still further notice to render 
their use intelligent and successful. 



REMEDY. 


INDICATED FOR WHAT. 


DOSE. 


acid, carbolic 


vomiting 


1 drop well diluted 
with water 


" " solution 


disinfectant wash 


q. s. 


" " ointment 


sores, burns, itching, 






etc. 


q. s. 


" hydriodic syrup 


asthma, hay fever 


1 teaspoonf ul in water 


" phosphoric dil. 


exhaustion of brain 


10 to 30 drops in water 


" salicylic 


rheumatism 


5 to 10 grains 


" tannic 


piles in suppositories 


2 to 3 grains 


acetanilid 


rheumatism to re- 






duce temperature 


2 to 5 grains 


aconite tinct. 


fevers 


1 to 2 drops in water 


" fl. ex. 


a 


£ to 1 drop in water 


alum pulverized 


croup, (emetic) 


10 to 60 grains in water 


ammonia — carbonate 


pneumonia 


5 to 10 grains 


" aromatic spir- 






its 


fainting 


| to 1 dram 


ammonia valerianate 






elixir 


hysteria 


1 dram 


anise water 


colic 


1 to 4 drams 



78 



THE NEW MEDICAL WORLD. 



REMEDY. 

anise oil 
arnica tinct. 



arsenic 



INDICATED FOR WHAT. 

colic 

bruises 

concussion of brain, 



cancers 

" sulphide skin affections 

atropia catarrh 

" with morphine severe pain 



belladonna tinct. 



bismuth subnitrate 
" subgallate 
blackberry root, tinct. 

wine or syrup 
buchu fluid extract 

burdock root — fl. ext. 

caffeine 

calcium sulphide 

camphor 

castor oil 
chalk mixture 

charcoal of wood pul- 
verize* 1 
chloral hydrate 

chloroform 



scarlet fever and 
many other dis- 
eases 

diarrhoea 

stomach distress 

diarrhoea 

irritable bladder or 

gravel 
chronic skin diseases 
weak heart or dropsy 
abcesses, carbuncles 

and acnae 
chordee, after pains, 

cholera 
laxative and cathartic 
antacid, summer 

complaint 

flatulence 

convulsions, . sleep- 
lessness 
convulsions 



Dover's powder cold, to ease pain 

elaterium dropsy 

Epsom salts or sulphate 
of magnesia cathartic 



DOSE. 

1 to 4 drops 
externally 

5 to 20 drops inter- 
nally 

A to iro g rain 

li o g rain 

t£t> g rain 

tablets internally or 

hypodermically, y-^ 

gr. atropia and J- gr. 

morphia 



1 to 3 drops 
3 to 60 grains 
5 to 10 grains 

one teaspoonful 

| to 1 dram 
L to 1 dram 
1 to 5 grains 

i to 1 grain 

1 to 5 grains 
1 to 8 drams 

1 to 8 drains 

10 to 20 grains 

5 to '20 grains 
3 to 10 drops cau- 
tiously inhale- 1 
5 to 10 grains 
j to J grain in pill 

1 to 4 drains in water 



THE NEW MEDICAL WOULD. 



79 



REMEDY. 

ergot fl. ext. 
gentian tr. comp. 
grino-er tr. 
gold thread 
grindelia robusta fl. 

ext. 
henbane tr. 

" fl. ext. 
iodine 
ipecac, wine of 

" syrup of 
iron tr. chloride 
iron reduced 
lavender spts. comp. 
lactucarium syrup 
laudanum or opium 

tincture of 
lime water 
lobelia tinct. 

magnesia cit. granular 

effervescent 
menthol 
morphia 

niter, sweet spirits of 
nux vomica, tinct. 

" " ext. 
opium 
pepsin pure 
paregoric 
peppermint spts. 
phenacetin 
pink root, and senna 

fl. ext. 
podophyllin 

quinine 

rhubarb, syr. aromatic 



INDICATED FOR WHAT. DOSE. 

hemorrhage 
dyspepsia 
colic, dysentery 
sore mouth, wash 

asthma 

diseases of bladder 

mania 

enlarged glands 

cough, bronchitis 

expectorant, emetic 

anasmia, erysipelas 

blood tonic — in pill 

flatulence 

cough 

pain, enemeta 
antacid 

expectorant, antispas- 
modic 

laxative and cathartic 
neuralgia, burns 
pain 

diuretic, in fevers 
anaemia, dyspepsia 
and constipation 

u a 

cholera, peritonitis 

dyspepsia 

cough 

nausea, colic 

pain and rheumatism 

worms 

biliousness, constipa- 
tion 

malaria, fevers 1 to 20 grains 

laxative for children 1 to 4 drams 



10 to 30 drops 

1 to 2 drams 
10 to 30 drops 
^ to 20 grains 

£ to 1 dram 
10 to 60 drops 

2 to 10 drops 
externally 
1 dram 
\ to 4 drams 
5 to 20 drops 
\ to 2 grains 
\ to 2 drams 
1 to 2 drams 

10 to 30 drops 
1 to 4 drams 

10 to 60 drops 

1 to 4 teaspoonfuls 
externally 

tV t0 I g rain 
\ to 1 dram 

3 to 10 drops 
(pills) \ to | grain 
1 grain 
1 to 3 grains 
\ to 1 teaspoonful 
20 to 30 drops 
5 to 10 grains 

\ to 2 drams 



iV to 



\ gram 



80 



THE NEW MEDICAL WORLD. 



REMEDY. 

salol 
santonin 
soda bicarb, 
soda, bromide of 
squill, syrup of 
squill syrup comp. 
strychnia 
sulphonal 
Tally's powder 



wild cherry syr. 



INDICATED FOR WHAT. 

rheumatism 

worms 

antacid 

nervousness 

expectorant 

croup 

paralysis, alcoholism 

sleeplessness 

after pains, stomach 

ache or pain in 

bowels 
cough 



DOSE. 

5 grains. 

1 to 3 grains 
5 to 60 grains 
5 to 20 grains 
^ to 1 dram 
8 to 30 drops 

t* o t0 *V grain 
5 grains 



5 to 10 grains 



VI. 



1 to '2 teaspoonfuls 
-HOUSEHOLD REMEDIES. 



It is unnecessary to have constantly on hand all the remedies 
mentioned in this book, some of them are rarely required and it is 
better to obtain them fresh as needed. There are a few remedies, 
however, which should be kept in every family to meet cases of 
emergency, especially if beyond the easy reach of a competent 
physician. 

This article follows the general description of medicines, and pro- 
poses to select from them a small list of those efficient remedies 
which arc appropriate for domestic use, tell you when they are indi- 
cated, and give all necessary instruction in regard to their action, so 
thai you can practically have the doctor with you to consult on all 
occasions. 

Household medicines should be kept together in some secure place, 
away from the reach of children, distinctly labeled with the name 
and dose. They should be kept tightly corked and excluded from 
the atmosphere as much as possible. It is a good plan to have the 
powerful remedies and poisions like aconite in round, two dram vials, 
and conspicuously labeled poison or caution. 

Liniments and external remedies, being used more freely, can be 
placed in square bottles, holding six ounces. A cough and diarrhiea 
mixture can be put in four ounce bottles. Some such plan, modified 
to meet the tastes and requirements of each family, will prove con- 
venient and satisfactory. 

This list might be easily extended, the chief difficulty being tO 
keep it within reasonable limits. These remedies arc not expensive, 



THE NEW MEDICAL WORLD. 81 

yet often worth a hundred times more than they cost, if at hand as 
needed. They can be used by an intelligent adult person who will 
give attention to simple details and make use of good judgment. 

This list does not contain anything like all the good remedies, but 
what it contains are efficient to accomplish the purposes for which 
they are directed, in so far as it is possible with a list of domestic 
remedies. Experience and careful attention to the other portions of 
this work will enable you to add other remedies to the list, or in 
some cases to substitute, for those suggested, others better adapted to 
special cases. 

Tincture of Aconite Root. — This is an excellent and powerful 
remedy, to be used in the early febrile disturbances of children or 
adults. It moderates the heart's excitement, relieves the congestion 
of the blood-vessels, checks the process of inflammation, and can be 
used with the best results by any intelligent person. Its effects 
should be watched, for it should be given less often when the pulse 
has declined to its normal condition and when free perspiration has 
been produced. The dose is from one to five drops of the tincture 
in water. One drop every hour is usually sufficient to produce the 
characteristic results. 

For a child one year old, put five drops into one half glass of 
water, and of this mixture give one teaspoonful each hour or half 
hour, depending upon the urgency of the case, till sweating is pro- 
duced and the fever symptoms abate, when it may be continued at 
less frequent intervals or discontinued as indicated by the symptoms. 

Tincture of Belladonna. — This is a remedy much used and popu- 
lar among the people who prescribe somewhat for their own family. 
The tincture can be used in the same dose and manner as aconite. 
Belladonna renders good service in the collapse of cholera infantum. 
It increases the capillary circulation, and relieves congestion of the 
internal organs. It improves the depth and character of the respira- 
tion and hence is much emplo} T ed in inflammations of the lungs and 
air passages. It is used in asthma, whooping cough, catarrh with 
profuse secretions of mucous, in headache, in neuralgia, and noctur- 
nal incontinence of the urine in children. It flushes the face in full 
doses, dilates the pupils, causes dryness of the mouth and throat, and 
excites the nervous system.- Atropia is the best form of using this 
powerful remedy. It can be obtained in soluble tablets containing 



v - THE NEW MEDICAL WORLD. 

one one-hundredth of a grain, one of which is an adult dose. For a 

child one year old, one of these tablets can be dissolved in ten or 
twenty teaspoonfuls of water, of which one teaspoonful is a suffi- 
cient dose, given every one or two hours. It may also be alternated 
with aconite, with good results, in fevers and inflammations of the 
lungs and air passages, or pleurisy. It is made use of extensively in 
eye practice, also in connection with morphia' hypodermic-ally, to 
relieve sciatica and other severe neuralgias and cramps ; also colic, 
either bilious, intestinal, uterine or renal. 

Atropia is an efficient remedy for night sweats. Belladonna oint- 
ment is a valuable application to an inflamed breast. It is also used 
locally to check the secretion of milk. 

Alum. — Pulverized alum is a serviceable and safe emetic in case of 
croup. It would be well to keep it on hand if there are children in 
the family liable to attacks of this urgent disease. The dose is one 
teaspoonful in water, to be followed by free drinking of warm water. 

Ammonia. — It is known also as hartshorn, or smelling salts, and is a 
convenient stimulant for inhalation in cases of fainting. A small glass- 
stoppered bottle of strong aqua ammonia will answer as well. If 
used internally it must be well diluted. A teaspoonful in a half 
u'lass of water and given in teaspoonful doses every half hour would 
be appropriate in an emergency, requiring the use of a stimulant. A 
teaspoonful dose of the aromatic spirits, if at hand, would be prefer- 
able. Some care must be exercised in the inhalation of ammonia, 
otherwise it might injure the mouth and produce inflammation of 
the glottis. 

Tincture of Arnica. — This is much employed domestically as m 

remedy for bruises. In case of much soreness or pain equal parts of 
thi' tincture of arnica and the tincture of opium form a valuable 
external application. It maybe applied freely, as needed, on a piece 

of clean muslin. 

Spirits of Camphor. — There are but few households probably 
where camphor is not included among the domestic remedies. It is 

a sort of habit to have a camphor bottle, even when no attempt is 
made to keep any medical supplies. A few drops will often relieve 

hysterical vomiting; it is also serviceable in flatulence. The dose is 
eight t«» twenty drops, well diluted with water. Camphor is service- 



THE NEW MEDICAL WORLD. 83 

able in summer diarrhoea, but as it enters into the composition of 
Tully's powder, which is given later, it requires no further mention 
here. 

Camphor Liniment. — (Camphorated oil.) — This is camphor gum, 
dissolved in sweet oil. It is an excellent emollient for many purposes. 
In pleurisy or inflammation of the lungs it can be used externally on 
flannel, or added to a flaxseed poultice just before applying it. It is 
somewhat warming and stimulating, it keeps the poultice warm and 
soft, and is a reliable and safe remedy. It is excellent to apply ex- 
ternally to all glandular swellings, such as appear in the neck in 
diphtheria and scarlet fever. It may be applied to bubo swellings 
in the groins and any acute glandular enlargements. It penetrates 
such indurations, softens them, relieves the congestion and inflamma- 
tion and often prevents suppuration. 

Camphor Liniment Compound. — This is composed of camphor 
liniment three parts and chloroform one part. This mixture has 
been prescribed and used for years by the author with the most 
happy effects. It makes a clear mixture and does not, like most 
liniments, separate. It is a liniment of great efliciency to apply to 
painful joints in gout and rheumatism, to painful swellings, sprains 
or wmerever a soothing application is needed. 

Castor Oil. — This isa valuable laxative for children, and it can be 
used with safety in the early stages of all diseases when there is 
inaction of the bowels. A small teaspoonful for a child is the proper 
dose. It is used in cholera infantum, combined with the tincture of 
opium or paregoric with happy results. (See cholera infantum.) 

The following elegant and palatable prescription may be used for 
giving castor oil : 

$ Castor oil two ounces 

Saccharin two grains 

Syr. acaciae half an ounce 

Syr. of liquorice half an ounce 

Wintergreen water one ounce 

Mix. Shake before using. Dose, one to four teaspoonfuls as 
needed. 

Tincture or Essence of Jamaica Ginger. — This is a good 
domestic remedy for colic in the bowels, or cramps in the stomach ; 



*4 I Hi: NEW MEDICAL WORLD. 

also diarrhoea with griping pains. The dose is ten to thirty drops or 
more in hot water. A teaspoonful of paregoric may be added for an 
adult and Increases its efficiency in all the range of its employment. 

Tincture of Iodine. — This is an excellent remedy for application 
to corns, bunions and chronic swellings of the glands or joints. It 
may be painted over such enlargements once or twice a day. It 
favors the absorption of chronic swellings. , 

Ipecac. The Syrup of. — This is a convenient emetic and expec- 
torant. It is given in colds, croup, coughs, or bronchitis in minute 
ilnscs and for vomiting. The dose is from one half to two teaspoon- 
fuls, repeated as necessary. The larger dose is for emetic purposes. 
It is a perfectly safe remedy. 

Menthol Liniment. — This is a very efficient remedy for head- 
ache, neuralgia, and superficial pains. The formula is as follow- : 

1£ Menthol one dram 
Alcohol two ounce- 
Oil of clove twenty minims 
Oil of cinnamon twenty minims 

Mix. This is to be applied externally as needed. 

Pills. For a safe and efficient pill see formula under constipation. 

Podophyllin. — This remedy in little granules or parvules. contain- 
ing one-twentieth of a grain, is an excellent cathartic for children ; 
one or more can be given at night, or night and morning, as 
required. 

Quinine. — This is a remedy that ought to be kept on hand* in 
malarial regions. The dose is from one to five grains in pills or 
powders. It is often given in much larger doses. It should be 
taken in connection with the podophyllin parvules, if the liver is 
inactive. (For formula see Malaria.) 

Syrup of Squill Compound. — (Hive Syrup.) — There is no better 
household remedy for sudden attacks of croup. It should be used 
with caution, as it is somewhat depressing in its action. It may be 

given with excellent results in acute colds, bronchitis and croup. It 

may be given in small and often repeated doses, or it" it is desired to 
hasten vomiting, increase the dose till such result is obtained. As 



THE NEW MEDICAL WORLD. 85 

soon as it has caused vomiting the dose, if continued, should be con- 
siderably reduced. The dose is eight to twenty droj>s. It should be 
given to feeble infants cautiously. 

A few other remedies are handy in case of emergency. 

The Oil of Clove. — A dram of oil of clove is a convenient remedy 
to have on hand in case toothache should occur suddenly at night. 
A piece of cotton saturated with the oil and placed in the cavity of a 
tooth affords temporary relief. Creosote is more efficient, but is a 
less safe remedv to use, and if handled carelesslv burns the lining: of 
the mouth and the skin. The two remedies may be combined. A 
prescription for toothache is found under that head. 

Lime Water and Sweet Oil. — Have a four ounce bottle of equal 
parts of lime water and sweet oil on hand to apply to burns and 
scalds. It is an efficient remedy and affords marked relief from pain. 
The old name for this remedy is Carron oil. 

Carbolized Ointment. — Prepare this useful ointment by adding 
ten drops of strong, pure carbolic acid to an ounce of vaseline ; if 
you wish a stronger ointment twenty drops may be added to an 
ounce of the vaseline. This makes an inexpensive domestic oint- 
ment which may be applied to burns, chapped hands, cracked lips, 
cold sores, itching of the skin and to other abrasions and sores as 
they occur. 

Ground Mustard. — This is an excellent domestic remedy. Do 
not allow yourself to be without it in the family. A teaspoonful, 
mixed with lukewarm water and taken, will produce speedy vomiting 
arid often perhaps relieve a person choked with a chunk of meat or 
piece of bone or other substance. Ground mustard is excellent to add 
to a foot-bath in case a person has been much exposed and has had 
wet feet during the day. Cloths wrung out of hot mustard water 
are excellent to apply to the surface in case of pain, vomiting or to 
stimulate the skin and bring out the rash of scarlet fever. It is useful 
in convulsions. A mustard poultice is a well-known and much-used 
counter-irritant. It is used to allay vomiting, applied over the 
stomach. 

It is serviceable in the first stages of pneumonia, pleurisy and to 
relieve many conditions of internal congestion and deep-seated pain. 
It will often relieve lumbago. The strength of a mustard poultice 



86 THE NEW MEDICAL WORLD. 

can be reduced by mixing it in any desired proportion with flour; and 
it can be prevented from blistering bv mixing with the white of an 
egg. A mustard poultice is much improved by adding to it a tea- 
spoonful or more of sweet oil. For small children the strength of 
a mustard poultice should be considerably reduced as the skin is very 
sensitive. 

Hot Water. — This has many uses both externally and internally. 
It has a large range of uses in the household. Taken internally it 
often relieves pain in the stomach, vomiting and dyspepsia. It can 
be safely used in fevers if it has been previously boiled, and in the 
chill stage of many diseases. It is useful for injections to allay hem- 
orrhages ; it must be used as hot as it can be borne for that. It 
relieves congestions and inflammations. A hot foot-bath often re- 
lieves slight congestion of the brain by drawing the blood away 
from the upper extremities to the general circulation. It is an ex- 
cellent dressing for slight wounds, sprains, bruises and the attendant 
pain. It should be used in the form of a hot pack, wrapped outside 
with flannel or oiled silk. 

Xotwithstanding the numerous valuable prescriptions contained in 
this work, the following for cough and another for diarrhoea will not 
bo out of place to complete this list of domestic medicines. 

COUGH MIXTURE. 

3 Muriate of ammonia two drams 

Muriate of morphia or codeina two grains 

Spts. of chloroform two drams 

Syr. of wild cherry two ounces 

Anise water enough to make four ounces 

Mix. Dose, one teaspoontul, and repeat in four hours as needed: 

DIARRHOEA MIXTURE. 

$ Tincture deodorized opium sixteen drops 

Subnitrate of bismuth two drams 

Syrup of blackberry root one ounce 

Cinnamon water two ounces 

Mix. Dose, a teaspoonful every two or four hours. 



THE NEW MEDICAL WORLD. v , 

This list of remedies, recommended for household use. contains 
about twenty medicines and ought not with the prescriptions 1 

cough and diarrhoea to cost more than two or three dollar-. 

Tully's Powder or Paregoric. — For stomach ache so common 
amonor small children it might he well to add Tully's powder. The 
adult dose is ten grains, for an infant under a year old one-half a 
grain is a sufficient dose. If preferred a few drops of paregoric can 
be used instead but the common and constant use of paregoric or 
soothing syrup to quiet cross children and keep them sleeping to 
avoid a racket is reprehensible. In sickness attended by pain it is 
admissible but in health it is injurious. 



CHAPTER IV. 
POISONS AND THEIR ANTIDOTES. 



1. Poisons in General. — II. The Mineral Acids. — III. Ox- 
alic Acid. — IV. Carbolic Acid and Creosote. — V. Acet- 
ic Acid. — VI. Ammonia. — VII. Prussic or Hydrocyanic 
Acid. — VIII. Arsenic and its Preparations. — IX. Cop- 
per, Mercury and Zinc Compounds. — X. Tartar Emetk . 
XI. Lead Compounds. — XII. Xitrate of Silver. — XIII. 
Phosphorus. — XIV. Opium and Morphine. — XV. Chlo- 
ral Hydrate. — XVI. Strychnia. — XVII. Aconite and 
Vegetable Poisons. — XVIII. Poison Ivy. — XIX. Poison 
Gases. 

I.—POISONS IN GENERAL. 

IT is somewhat difficult to give a satisfactory definition of poisons 
because there are so many vegetable, mineral and animal suii- 
Stances which come under this head and because there are so many 
substances, like the chloride of sodium, (common salt,) which are 
poisonous in large doses and yet harmless or essential to life in small 
quantities. 

There are some substances which are poisonous only when sepa- 
rated from the inert material by which they are diluted. Oxygen, 
which is always essential to the maintenance of life is poisonous when 
separated from the nitrogen which dilutes it sufficiently for 
breathing purposes. A person inhales enough carbonic acid dur- 
ing twenty-four hours to destroy life if breathed alone by itself. 

Some of the properties of plants are harmless in their natural com- 
binations but when their medicinal virtues are concentrated or their 
active principles separated they may act as violent poison-.. The 
common sorrel and pieplant contain oxalic acid; and the leaf and 
bark of the cherry and peach trees, also the pit of the latter, contain 
prussic acid, a most deadly poison. 

The active principle of aconite, known as the alkaloid aconitia i> 
•i fatal poison in the dose of one-twentieth of a grain, the medicinal 



THE NEW MEDICAL WORLD. 89 

dose being from one two-hundredth to one four-hundredth of a grain. 

Some substances are poisonous simply because their strength is 
concentrated but when sufficiently diluted are harmless. Muriatic acid 
is a powerful common poison, burning and destroying the tissues, yet 
in diluted form it is a useful medicine and it is also a constituent of the 
normal gastric juice. 

Phosphorus is an energetic poison but its compounds exist in many 
articles of our daily food and it is essential to the growth of the bod- 
ily tissues, the bones containing it in large quantities. 

We shall simply regard poisons as those substances which destroy 
life, without attempting a comprehensive definition. There are three 
classes of poisons, mineral, vegetable and animal. Some of the most 
active as prussic acid, strychnia, aconite, hyoscine and many others 
are obtained from the vegetable kingdom. 

Poisons usually act upon the system in one of two ways ; chemically 
or physiologically. By the first method they unite with the fluids of 
the body with which they come in contact and corrode a layer of the 
tissue leaving it as if charred; the vitality is destroyed as deeply as 
the corrosive substance can penetrate and there is superficial death of 
the corroded layer. By the second method the poison is absorbed, 
enters the circulation and produces some definite condition or physi- 
ological result. 

The strong mineral acids are poisonous by means of their corrosive 
action. They produce death of the soft tissues to which they are 
applied. Opium illustrates the action of the second method. It does 
not act chemically. It has no power to destroy the life of a tissue 
but it is absorbed into the system and in poisonous doses stupefies 
the brain and certain nerves whose action is essential to the process 
of respiration and the continuation of life. The processes of life 
become fainter and fainter, the breathing takes place at unusually 
long intervals until it ceases altogether and the whole machinery 
stops. 

There are several ways by which poisons may enter the system, the 
most common method is by being taken into the mouth and stomach. 
Some poisons exist in the form of vapor and gas and enter the sys- 
tem by being inhaled. The vapor of prussic acid cannot be safely 
inhaled ; even the smallest amount is not without great danger. It 
produces fatal results almost instantly and where a case of poisoning 
occurs from this powerful agent the physician rarely has an oppor- 
tunity to reach the victim before death has occurred. 



90 THE NEW MEDICAL WORLD. 

Some poisons are occasionally introduced into the system through 
an abrasion in the skin, or a wound, or it may be injected into the 
cellular tissue beneath the skin. The poisons of rabid animals and 
serpents are introduced by means of a wound or bite. 

Some poisons reach the system simply by contact with the skin. 
Poison ivy acts in this way. Lead is absorbed into the system from 
hair-dyes and mercury from cosmetics. 

Cases of belladonna poisoning have occurred from its extensive 
application externally in the form of plasters. 

ANTIDOTES. 

Antidotes are substances which antagonize the action of poisons 
and render them more or less harmless. Some of the antidotes for 
the mineral acids are alkalies which neutralize their action by con- 
tact. Other poisons are antagonized by physiological antidotes. 
These set up an action in the system which is opposed to the action 
of the poison and thus its effect is counteracted until nature can 
eliminate it. 

There are some general principles to be observed in treating those 
who have taken poisons. 

It is necessary in the first place to get rid of the poison as soon as 
possible. Nature often accomplishes this end by means of vomiting 
and thus irritating poisons are often expelled. The process of vom- 
iting is favored by the abundant administration of lukewarm water. 
[f the poisonous substance does not itself produce vomiting, admin- 
ister an emetic. The sulphate of zinc is an excellent emetic in doses 
of from five to twenty grains. It is rapid in its action and it does 
not produce depressing effects like many other emetics. Ipecac, 
either the syrup or teaspoonful doses of the fluid extract, stands sec- 
ond on the list, or from fifteen to thirty grains of the powder may be 
Stirred into warm water and drank freely. Ipecac can be taken in 

considerable quantity as it does no injury and the dose can be fre- 
quently repeated till it acts. When these cannot be obtained do not 
wait tor their arrival but use ground mustard, a teaspoonful or more 

in warm water and repeat frequently. Common salt may be used in 

uarin water. Vomiting is hastened by tickling the throat or fames 

with the finger or a feather, also by the copious administration of 
lukewarm water. In the hands of a physician apomorphinc may be 
used tO cause vomiting. It is a certain emetic. The dose \s from 

one-tenth t<> one-twentieth of a grain injected under the skin. 



THE NEW MEDICAL WORLD. 91 

Poison introduced by the bite of a rabid dog requires energetic 
treatment (see hydrophobia) ; the wound should be speedily and 
thoroughly cauterized. It is customary to recommend sucking a 
poison wound immediately. This can be done without danger if 
there is no abrasion about the mouth to favor the absorption of the 
poison and if the wound is not extensive. 

It is seldom that all the poison taken can be expelled by vomiting 
hence other measures are made use of, as the administration of an 
antidote. There is no universal antidote for all poisons, but the 
special antidote to be used in each case will be mentioned in connec- 
tion with each particular poison or group of poisons. 

Antidotes should be such remedies as can be freely administered 
without further danger. They should act quickly and be able to 
counteract the danger which arises from the use of the poison. It 
often happens that too much time has elapsed between the taking of 
a poison and the administration of an emetic or an antidote. The 
poison which has been absorbed and sent all over the system cannot 
be expelled by vomiting, and antidotes in these cases will not always 
avail. 

In many instances it is necessary to combat the unfavorable symp- 
toms which arise by stimulants, or remedies which produce upon the 
system the opposite effects of the poison. When poisons suspend 
the act of respiration artificial respiration performed for a certain 
time as indicated is sometimes sufficient to avert death. Life some- 
times trembles in the balance and a little prompt action is often the 
means of changing the result from death to life. 

II.— THE MINERAL ACIDS. 

Bicarbonate of soda 



Sulphuric acid 

Muriatic acid 

, TV . . , > Antidotes 

.Nitric acid f 



Chalk 
Magnesia 



Nitromuriatic acid J [ and other alkalies 

In poisoning from the mineral acids vomiting will not avail. It is 
necessary to neutralize the acids with alkalies ; prompt action is es- 
sential. In case cooking soda is not at hand make a solution of soap 
by shaving it up, mixing it with warm water and administer quickly. 
After the copious use of the. antidotes give milk, olive oil, mucilage 
or whites of eggs. These substances can be mixed with the anti- 
dotes and given together. 



9*J THE NEW MEDICAL WORLD. 

For acid in the eye use a wash of common baking soda (bicarbon- 
ate of soda) and then use oil to allay the irritation. 

These acids taken into the stomach are corrosive and produce 
inflammatory conditions of the alimentary canal of a severe type. 
(Treat pain in the mouth and distress in the stomach are experienced. 
It is difficult to administer the antidotes quickly enough to prevent 
serious results. 

III.—OXALIC ACID. 



Chalk 



Antidotes { T . , 

Lime 

Magnesia 

Occasional poisoning from oxalic acid has occurred on account of 
its great resemblance to Epsom salts. Druggists have in occasional 
instances sold oxalic acid by mistake for Epsom salts. The tastes of 
the two drugs are different. Oxalic acid has a sour taste and the 
well-known saline purge is extremely bitter ; but many times a dose 
of salts is mixed with water and swallowed too quickly to recognize 
the difference even when a mistake has been made. It is a violent 
poison and produces the following symptoms : Great anxiety, ex- 
treme pain, great thirst, swollen tongue, violent efforts to vomit, 
marked debility and prostration. The mouth and throat appear as 
if scalded, and the mucous lining of the stomach is more or less in- 
jured or destroyed by a fatal dose. 

The antidote must be used with haste. Chalk or magnesia 
mixed with milk or water, should be drank freely. Vomiting may 
be encouraged by drinking a teaspoonful of mustard mixed with 
warm water. Also tickle the throat with the finger or a feather. In 
case no other remedy is at hand, take lime from the walls of the 
house, crumble it into water and drink it. Stimulants are necessary 
to combat the depression of the vital forces. The much used pie 
plant contains oxalic acid, and children are sometimes made sick by 
its extensive use in the spring when it grows abundantly. 

[V.— CARBOLIC ACID AXD CREOSOTE. 

. . , ( Olive oil or whites of eixurs. 

Antidotes. \ Be 

( Sacoharate or lime (lime and sugar). 

[f strong carbolic acid or creosote is taken internally, it acts as an 

irritant and corrosive poison. A teaspoonful has been known to 



THE NEW MEDICAL AV0RLD. 93 

produce fatal results. Olive oil should be freely used. The saccha- 
rate of lime is the best antidote, but not likely to be at hand. Mus- 
tard and warm water should also be given to provoke vomiting. 
Obtain the saccharate of lime, if possible, and give it in solution. A 
dose of Epsom salts should be given, and hot applications and stimu- 
lants as demanded. The symptoms are violent vomiting and purg- 
ing, burning pain in the stomach and bowels, a pinched look, weak 
pulse, difficult breathing and collapse. 

V.— ACETIC ACID, OR STRONG VINEGAR. 



Antidotes. 



" Baking soda 
Lime water 

Carbonate of magnesia. 
Soap water. 



After neutralizing the acid, administer olive oil, flaxseed tea or 
mucilaginous drinks. 

VL_AMMONIA. QUICK LIME. 

Lye of wood ashes. Caustic potash or soda. 

. _, ( Vinegar 

Antidotes, u . . 

( Lemon juice. 

When ammonia has been taken by mistake it produces irritation 
and caustic action upon the mucous membrane. Give diluted 
vinegar, olive oil, and milk. 

VIL— PRUSSIC ACID, OR HYDROCYANIC ACID. 

CYANIDE OF POTASH. 

Antidote. — There is no chemical antidote. 

Ammonia or chlorine are recommended. 

This is the most potent and speedily fatal of all the poisons, acting 
almost instantly in many cases. 

The symptoms of poisoning by prussic acid are loss of sense, diffi- 
cult breathing, coldness of the extremities, weak pulse and convul- 



9-4 THE NEW MEDICAL WORLD. 

sions. The poison is absorbed with great rapidity and the victim 
often drops dead with a gasp. If life continues for twenty or thirty 
minutes it is to be regarded as a favorable sign. 

Peach pits, bitter almond oil, cherry laurel water and some other 

.table substances, as peach tree leaves and wild cherry, contain 

prassic acid. Twenty peach pits have been known to fatally poison 

a child, eaten upon an empty stomach. The treatment indicated i> 

the best that can be used for this class of poisons. 

Throw cold water on the face, use inhalations of ammonia, also 
give ammonia internally; see that it is properly diluted : use friction 
over the chest and abdomen ; keep up the respiration by artificial 
means ; apply warmth. Moisten chloride of lime to liberate the 
chlorine, and cause the gas to be inhaled. Atropia, hvpodermically, 
would no doubt prove beneficial, as it increases the respiration. A 
physician rarely has the opportunity to treat a case of poisoning by 
this assent, so speedily fatal is its action. Other remedies could be 
suucrested by a medical man, as the sulphate of iron, but those sug- 
gested above are the most practical, and the easiest to obtain in 
haste, which is a good point in the treatment. 

VIII.— ARSEXIC AND ITS PREPARATIONS. 

Antidote. — The hydrated sesqui-oxide of iron with magnesia. 

Arsenic in large doses usually excites vomiting. This action is to 
be favored by the administration of ground mustard mixed with 
warm water. Also tickle the throat with the finger. The stom- 
ach should be washed out by the stomach pump. Dialvzed iron, 
a fluid and somewhat feeble preparation, may be used as an an- 
tidote t<» arsenic in doses of from fifteen to thirty minims. The usual 
antidote to arsenic is the hydrated sesqui-oxide of iron, and it is pre- 
pared thus : 

Take a pint of the muriate tincture of iron, add to it ammonia or 
magnesia to precipitate the iron ; strain off the liquid through a mus- 
lin and wash out all the ammonia; this leaves a sediment like 
iron rust, which is harmless and can be administered freely. This 
antidote may be administered with magnesia, which is also an anti- 
dote. 

The symptoms of arsenical poisoning are violent gastritis, with 
vomiting and purging, cramps, great pain in the stomach and abdo- 
men. The bowels art' denuded of the nnicous membrane, which 



THE NEW MEDICAL WORLD. 95 

passes off in shreds. To meet these conditions, opium should be 
given to alia}' pain and vomiting, or still better, morphia, hypoder- 
mically. Milk, olive oil and the whites of eggs should be taken in- 
ternally. Fluids should be freely used to enable the kidneys to 
eliminate the remaining poison. 

Death may occur from arsenic several days or even weeks after 
the poison has been taken and when there appears to be promise of 
complete recovery. 

IX.— COPPER, MERCURY AND ZINC COMPOUNDS. 

The more common of these poisons and their names are : Blue 
vitriol, verdigris, corrosive sublimate, vermilion, the white and red 
precipitate, and white vitriol. 

These poisons coagulate albumen and enter into combination with 
it. Therefore give the whites of eggs freely, then warm mustard 
water to excite vomiting. After free vomiting, give the whites of 
eggs and milk, also olive oil, and apply mustard poultice over the 
stomach to relieve the gastic symptoms. 

Copj>er salts in poisonous quantity cause violent, burning pain in 
the stomach, and metallic taste in the mouth, the vomiting of glairy 
mucous, great exhaustion, and also convulsions. Corrosive sublimate 
in overdoses causes violent pain, vomiting of mucous and blood, 
metallic taste in the mouth, and an eroded condition of the mucous 
lining of the mouth, purging of mucous and blood, collapse and 
death. 

X.— TARTAR EMETIC. 

ALSO KNOWN AS TARTAEIZED ANTIMONY. 

Antidote. — Tannin in large doses. 

As tea and coffee contain tannin, strong infusions of either may be 
used instead, unless the symptoms are severe. Warm water freely 
taken will render the process of vomiting more tolerable, also extreme 
heat should be applied, stimulants, and perhaps morphine, hypoder- 
mically. 

The symptoms of antimony poisoning are violent vomiting of 
mucous, fluids, bile and blood, also violent purging. Later the rice 
water stools appear, very similar to those in Asiatic cholera. The 
pulse is rapid, feeble and flickering. The respirations are faint, 



96 THE NEW MEDICAL WORLD. 

fluttering and shallow. The temperature falls if death approaches, 
and cramps in the legs attack the patient on account of the removal 
of liquids from the tissues. 

XI.— LEAD COMPOUNDS. 

SUGAR OF LEAD, WHITE LEAD, LITHARGE. 

Antidote. — Epsom salts (sulphate of magnesia.) 

Give an ounce of Epsom salts dissolved in water. But first pro- 
mote vomiting by giving ten to fifteen grains of sulphate of zinc dis- 
solved in water, or mustard water. Hot applications should be applied 
to the feet and hands, and the pain and irritation relieved by doses of 
opium. Milk and eggs are serviceable and soothing. The symptoms 
of lead poisoning are obstinate constipation, pain in the stomach, 
vomiting, rapid pulse, anxious face, thirst, cramps and muscular 
twitching. 

XII.— XITRATE OF SILVER. 

Antidote. — Common Salt (Chloride of Sodium). 

Common salt solution neutralizes the action of this poison. The 
whites of eggs and mucilaginous drinks or olive oil should be given, 
after vomiting has been provoked by warm mustard water. The 
symptoms are pain in the abdomen with vomiting and purging. The 
face is anxious and covered with perspiration. The lips are stained 
brown or black and convulsions may occur. 

xiii.— phosphorus. 

There is no certain antidote for this poison. It should first of all 
be removed from the stomach by vomiting and other available means. 
Kinetics of mustard and warm water or ipecac should be adminis- 
tered. Vomiting should be followed by giving calcined or carbonate 

of magnesia or cooking soda, .Mix a teaspoonful of either with water 
or gruel and give as soon as vomiting has taken place. Nothing 
containing oil or fat is admissible in phosphorous poisoning. It is to 
be remembered that oils are serviceable in every other kind of poi- 
soning, especially when the tissues are corroded, but as oil favors 
the absorption of phosphorus it should never be given after ac- 
cidental poisoning by this agent, Turpentine formerly regarded as 
an antidote is no longer used. 



THE NEW MEDICAL WORLD. 97 

The symptoms of poisoning by phorpkorus are so violent that it 
is never taken intentionally for suicidal purposes but only by acci- 
dent. The symptoms are violent pain in the stomach, vomiting, di- 
arrhoea, great distress in the stomach and bowels, and convulsions 
with the approach of death. 

Care should be taken in every family to keep matches out of 
the way of children. A phosphorous paste is used for the destruc- 
tion of rats. Such active agents should be used if at all with espe- 
cial caution. 

XIV.— OPIUM AND MORPHINE. 

The first indication is the removal of the poison from the stom- 
ach. Give twenty grains of the sulphate of zinc or strong mustard 
water to provoke free vomiting. Prevent the patient from going to 
sleep. Give ammonia by inhalation and keep the patient aroused 
by dashing cold water on the face or making the patient walk to and 
fro. Flagellations are sometimes employed. Administer tannin or 
strong coffee and in extreme cases resort to artificial respiration. 
One one-hundredth of a grain of atropia should be given hypoder- 
mically. Stimulants may be necessary. Efforts should not be re- 
laxed until the patient is out of danger or so long as life continues. 

The symptoms are drowsiness, deep sleep, slow pulse and con- 
tracted pupil. In the worst cases the face becomes pale, the respira- 
tions decrease sometimes to four or five a minute, the breathing 
becomes very shallow and in fatal cases the patient becomes so deeply 
narcotized that no effort can arouse him from this condition. Death 
results from the failure of respiration. 

The tincture of opium (laudanum) is often used with suicidal 
intent. Soothing syrups have sometimes destroyed the lives of chil- 
dren by means of the large amount of opium or morphine which they 
contain. Carelessness in constantly repeating prescriptions contain- 
ing opium is to be observed by watching the drug business and is 
censurable. 

XV.— CHLORAL HYDRATE. 

Promote vomiting by the administration of warm mustard water 
or fifteen to twenty grains of the sulphate of zinc dissolved in water. 
Give strong tea and coffee. Artificial respiration must be employed 
if necessary. Stimulants with the exception of ammonia are indi- 
cated. 



'» v THE NEW MEDICAL WORLD. 

Strychnine should be given to stimulate the respiration ; one-for- 
tieth to one-twentieth of a grain will be needed in these cases, or 
atropia may be used for the same purpose in doses of one-ninetieth 
of a grain. 

The symptoms of poisoning which develop from a fatal dose are 
sleep followed by coma, the respiration becoming slow and labored 
and gradually getting shallow and feeble. The pulse becomes thready, 
Hiekering and at length ceases at the wrist. The face is pale, the 
body is covered with a cold sweat and the pupils are widely dilated. 
The whole muscular system is in a state of marked relaxation and 
sometimes no effort succeeds in arousing the patient. 

XVI.— STRYCHNIA. 

(The alkaloid of mix vomica.) 

In treating strychnia poisoning nitrite of amyl is an excellent rem- 
edy to control convulsions. Three or four drops as needed may be 
placed upon a handkerchief and inhaled. Excite vomiting by means 
of strong mustard water and tickling the throat. Give tannin in 
water. This is a chemical antidote. After the stomach has been 
emptied by vomiting give bromide of potash, thirty grains and chloral 
hydrate, fifteen grains, in water sweetened to taste. Chloroform may 
be inhaled to relax muscular spasms. If relaxation does not occur the 
injection of nitrite of amyl hypodermically should be tried. The 
symptoms of strychnia poisoning are convulsions. The contractions 
of the muscles are attended by pain and the patient dies from spasm 
of the chest muscles which prevents respiration. 

XVII.— ACONITE AND VEGETABLE POISONS. 

There is still a large list of vegetable poisons, but as they are 
rarely used with suicidal intent, and not as likely to be used acci- 
dentally as those already mentioned, it will be unnecessary to 
describe each one by itself. Aconite well represents this class. 
When any vegetable poison has been taken, exeite vomiting as 
quickly as possible, then give milk, or strong coffee, also stimulants, 
if necessary. 

XVIII.— POISON IVY. 

Poisoning by this agent needs to be noticed because of its preva- 
lence. Ivy is a climbing plant, very common in hay Melds, and about 



THE NEW MEDICAL WORLD. 99 

old walls and fences. Some are more severely affected by coming in 
contact with it than others. It produces a fiery inflammation of the 
skin, characterized by itching, redness and the formation of vesicles. 
It should be treated with soothing lotions, as equal parts of lime 
water and sweet oil, or a solution of bicarbonate of soda, or either 
of the following : 

I£ Hyposulphite of soda one ounce 

Carbolic acid one and a half dram& 

Glycerine two ounces 

Water enough to make eight ounces 

Mix. Apply upon cloths and repeat frequently. 

3 Benzoinal four ounces 

Carbolic acid one dram 

Cocaine thirty grains 

Mix. Apply as needed. 

There are a number of occupations which, if long continued, result 
in a chronic condition of poisoning ; the most common among which 
are those occupations which require the use of phosphorus, lead and 
mercury. 

Those who work in match factories, thermometer manufactories, 
paint shops and similar places, should exercise all the more generally 
known precautions, and abandon the occupation for one more health- 
ful if symptoms of poisoning appear. 

Poisoning of chronic form has occurred from the use of cosmetics^ 
hair dyes and fabrics colored by the arsenical pigments. 

Lead, mercury and arsenic are the three poisons which are most 
used in a great variety of ways, and concerning which it is necessary 
to be on guard. Most of the hair dyes contain lead and are danger- 
ous to apply to the scalp ; and much ill health and some cases of lead 
palsy have resulted from their use. 

The best way to escape the dangers that lie concealed in prepara- 
tions for the hair and complexion is to avoid them. In the long run, 
cosmetics injure and destroy the complexion more than they beautify 
it. There is really no sufficient excuse for the use of such prepara- 
tions as involve the risk of poisoning. 



100 THE .NEW MEDICAL WOULD. 

XIX.— POISON GASES, 

Gases with few exceptions have a poisonous action when breathed 
into the lungs or inhaled. 

The severity of the condition manifested usually depends upon the 
concentration of the gas and the length of time it has been inhaled. 

If sufficiently mixed with atmospheric air no evil consequences 
except headache, vertigo, pallor and nausea may be experienced. 

Danger attends the burning of coal and charcoal when used foi 
fuel in rooms unventilated and having no chimney exit ; for death 
lias frequently resulted from the gas escaping from these substances 
under these circumstances. 

Sewer gas has caused death when its inhalation has been pro- 
longed as in the case of workmen engaged in the construction of the 
Thames tunnel. 

Illuminating gas being made from coal is quickly poisonous when 
inhaled in concentrated form. If well mixed with atmospheric air 
its action is less speedy and fatal. 

The gas fixtures in houses should be so constructed as to preclude 
any possible danger from escaping gas. 

Gas has a peculiar and offensive odor, easily recognized when a 
person first enters a room, going from the outside air ; but the gradual 
escape of gas into a room may be unperceived by the occupant, and 
more especially if sleeping. 

Persons, unaccustomed to the use of gas, visiting a large city for 
the first time have sometimes lost their lives by blowing out the 
flame instead of turning it off. 

When gas escapes into the atmosphere of a room it forms with 
the aii- an explosive mixture ; hence when a strong smell of gas is 
perceived in any room no lighted flame should be introduced until 
the main supply has been turned off and the room ventilated. 

TREATMENT. 

When a person has been overcome by gases, whether illuminating, 
coal, or charcoal <jas, he should be removed from the poisoned 
atmosphere to the fresh air and placed in a reclining position. Cold 
water, if the patient is warm, should be sprinkled or poured over the 
head and spine, or if the external surface is cold, warm water should 

be preferred. 



THE XEAV MEDICAL WORLD. 101 

Artificial respiration (see drowning) should be performed until 
respiration is established or the patient's condition is known to be 
hopeless. 

Other measures such as stimulants or the subcutaneous injection of 
atropia and strychnia will be instituted by the medical attendant 
upon his arrival. Each case must receive the treatment favoring 
recovery which the patient's condition requires. 

Poison gases the product of the laboratory in limited quantities 
need no attention here, as they are demanded only by scientific work- 
ers who know how to handle them. They are often so irritating that 
their inhalation is avoided and if a single breath is inhaled the victim 
rushes to the fresh air which is in most cases the only needed anti- 
dote 



CHAPTER V. 

THE USE OF ALCOHOL AND OTHER DAN 
GEROUS OR NARCOTIC DRUGS. 



I. Alcohol, Its Use and Abuse. — II. Chronic Alcoholism. 
III. The Morphine, Cocaine and Chloral Habits. — IV. 
The Effects of Tobacco. 

I.— ALCOHOL, ITS USE AND ABUSE. 

IT is to be regretted that a large portion of the civilized world 
makes a common nse of alcoholic drink. The daily nse of such 
beverages is superfluous and harmful. The healthy individual does 
not need them and they cause in the aggregate a large amount of 
mental and physical disease which frequently terminates in death. 

Alcohol is a necessary medicinal agent and is often beneficially 
though perhaps too frequently prescribed by the physician, but when 
habitually used by the individual it is the most unsuitable and harm- 
ful of all remedies. 

It will be necessary to consider the action of this agent in health 
and in disease in order to understand its proper and improper use. 

The first action of alcohol upon a healthy person is as a stimulant. 
It powerfully forces the heart and when taken in considerable quan- 
tity increases its action several beats each minute. It is difficult to 
compute the excess of work which it is obliged to perform urged on 
by this agent. The face is flushed and all the blood vessels are in a 
condition of temporary congestion. The brain, spinal cord, liver, 
lungs, spleen and kidneys are also in a state of temporary congestion, 
a condition which becomes chronic after long continued use. 

It is well known that the harder a machine Is driven and the higher 
the rate of speed the greater the wear and tear, owing t«> the in- 
creased amount of friction developed. 

Alcohol increases the speed of that human machine, the heart caus- 
ing strain and overwork of that organ, also congestion of the blood 
vessels of the various organs of the body and hence is detrimental 
•>nd dangerous to the healthy man. 



THE NEW MEDICAL WOK LI). 103 

Alcohol itself like many other things used medicinally, may be re- 
garded as an active poison, for fatal cases sometimes occur among 
children who accidentally find and drink it. It may produce such 
severe inflammation of the stomach or such violent congestion of the 
brain or such abnormal disturbances of natural processes as to cause 
death on the part of those unaccustomed to its use. 

The proper use of alcohol as a stimulant is seen in depressing sick- 
ness and in emergencies. In these cases it can be used to antag- 
onize the tendency to heart failure and maintain life till nature is able 
to assert itself. 

The action of poison upon the system may seem to paralyze the 
life forces. The heart strike becomes feeble and threatens to fail 
altogether. Then this ao-ent is the most reliable antidote known. 

There are a few diseases or stages in certain diseases when it is 
sometimes strongly indicated and its use becomes a necessity, but it 
is ever to be remembered that its administration must be carefully 
guarded and cease as soon as it can be safely omitted. 

In the late stages of typhoid fever and pneumonia, after the excite- 
ment of the inflammatory stage has subsided, it may be needed to 
prevent heart failure and its wise administration may sometimes save 
life. In the acute stages of most diseases it is uncalled for and is 
capable of producing harm ; for it quickens the jmlse too much, in- 
creases congestion of the internal organs, augments inflammatory 
action and aggravates many of the early symptoms. Its use must 
be reserved for strengthening the waning life forces as manifested by 
the flagging of the heart. 

In some conditions, however, when used medicinally, it exerts 
another important and almost contrary action to what it does in 
health. In these cases, when its use is demanded, it prevents the 
rapid waste of muscular tissue, thus conserving the strength. It 
may so strengthen and steady the pulse which has become excited, 
rapid and thready from exhaustion and weakness, that it 
declines in frequency and manifests greater energy. The flickering, 
weak action of the heart is changed to a nearly normal condition. 

Alcohol used medicinally in appropriate cases may be said to have 
an effect directly opposite from what it has when used in health or 
injudiciously and inappropriately. It has its true j^lace in medicine 
as well as arsenic, strychnia, aconite and other powerful remedies. 

It is no wonder that some persons have acquired such a prejudice 
from its destructive and demoralizing action upon the human family, 



104 THE NEW MEDICAL WORLD. 

through its misuse, that they deny that it has a legitimate place even 
when judiciously prescribed. The successful practitioner cannot fail 
to recognize this fact, and he must only make use of this powerful 
agent in such a way as commends itself to his conscience, reason and 
experience. 

Ordinarily, alcohol as a stimulant or nutrient is rarely required in 
the diseases of children. It is more often appropriate and service- 
able in the diseases of the aged, the infirm, and those greatly 
debilitated, where the circulation is sluggish, and all the processes of 
life are verging towards the minimum. 

From the standpoint of the moralist alcoliol is appropriately re- 
garded as a great evil. Its wrecks lie thi<ajdy about us on all sides, 
like the driftwood along the river banks after a freshet. From the 
standpoint of the conscientious physician, alcohol is a medicine, inju- 
rious in health, destructive to honesty, reliability, morality and charac- 
ter ; the def amer of home, the blighter of prospects, the sorrow of wife- 
hood and motherhood, the parent of filth, disorder, rags, poverty and 
dishonor, but on the other hand, a remedy whose judicious employ- 
ment by skillful hands may save the inestimable life of a father, 
mother, brother, sister, husband, wife or sweet infant. It is a rem- 
edy, like strychnia, to be relegated to its appropriate sphere, and 
confined and limited to its legitimate place; a remedy which, if per- 
sistently used, will easily make you a slave, and slowly and surely 
work your destruction. 

Owing to the dreadful danger which lurks in the stimulating cup, 
which first fascinates and then intoxicates, the author earnestly 
advises that alcohol in all forms be shunned except in dire emer- 
gencies, or when recommended and employed by the cautious and 
conscientious physician. 

II.— CHRONIC ALCOHOLISM. 

When alcohol is indulged in habitually, it works a great variety of 
changes, some of which occur in the corpuscles of the blood, and 

others in the tissues of the body. The rapidity of these changes 
cannot be foretold. They depend upon individual traits, constitu- 
tion, temperament, occupation, habits, and the inherent tendency to 
weakness on the paii, of certain organs. The extent and degree of 
these changes depend upon the amount consumed and the duration 

Of itfi |l M .. 



THE NEW MEDICAL WORLD. 105 

The early effects produced are functional changes, such as derange- 
ment of the digestive system. The mucous surfaces are irritated and 
congested, a condition which is liable to be followed by catarrhal 
inflammations. These functional changes at length interfere with 
the normal action of the various organs. The tissues are perverted, 
their thickening, shrinking and inaction follow. 

When structural degeneration takes place, the functions of the 
bodily organs are more seriously interfered with. Years may inter- 
vene before well marked organic changes follow these functional 
disturbances. 

The system for a time becomes somewhat accustomed to its use, 
and in spite of it is able to maintain health, sometimes for a long 
period, but injurious changes are sure to come, for they are slowly 
and steadily advancing. They are none the less real or injurious 
because insidious in their approach. 

Among the earlier symptoms which awaken attention are dyspep- 
tic troubles. All forms and every degree of gastritis accompany 
alcoholic excesses. The small vessels of the mucous coat of the 
stomach are dilated, congested and at length inflamed. The glands 
of the stomach are enlarged. The appetite is variable and irregular, 
there is a distaste for food in the morning. Flatulence, sour stomach 
and heart burn are common. Gastric ulcers are not infrequent, and 
permanent changes in the mucous membrane take place. 

Next to the stomach the liver is disturbed by the excessive use of 
alcohol. The injury to this organ is usually serious and severe. Al- 
cohol is taken up by the absorbent vessels and carried by the portal 
circulation directly into the circulation of this organ, where it in- 
duces prominent symptoms and serious changes, depending upon 
the amount and quality of the stimulant which is consumed. Dis- 
eases of the liver are far more numerous among hard drinkers, espe- 
cially those who consume the strong beverages as whiskey, brandy 
and gin than among any other class. The first action which alcohol 
produces in the liver is congestion, next inflammation, then at length 
follow those characteristic changes which are so well known to med- 
ical men as B right's disease, yellow atrophy of the liver, fatty degen- 
eration and perhaps diabetes. 

Some of the symptoms of these diseases which alcohol drinkers 
manifest are vomiting, headache, constipation or diarrhoea, muscular 
tremor, vertigo and mental depression. Still more suggestive symp- 
toms are jaundice, dropsy, hardening of the liver (cirrhosis), produc- 



10*3 THE NEW MEDICAL WORLD. 

ing emaciation and interfering with the function of every bodily or- 
gan. These severe symptoms commonly progress slowly and almost 
always lead to a fatal termination. 

Alcohol drinkers are especially liable to that dreaded disease, pneu- 
monia. Owing to the fact that alcohol produces congestion of the 
capillary blood vessels it predisposes to attacks of pneumonia, which 
are especially fatal in such subjects as is well known. Fatal attacks 
of bronchitis are also common among hard drinkers. 

The blood vessels surfer from the effects of the drink habit. There 
is degeneration of their tissues especially in the arteries, their elas- 
ticity is lost, the walls become thin and allow extreme dilatation and 
under severe pressure the vessels give way and death ensues. This 
is the case when apoplexy terminates their career. 

The heart usually suffers to a greater or less extent. There may 
be hypertrophy of this organ or fatty degeneration. The heart power 
is enfeebled and there is degeneration of the heart muscle. The 
stimulant at length fails to stimulate and when such is the case the 
vital powers must soon fail. Such persons after a brief illness are 
prone to die with symptoms of heart failure. As the stomach, liver 
and heart undergo structural changes so the kidneys suffer degenera- 
tion, the vessels lose their elasticity, the membranes become weak- 
ened and permit the albumen of the blood to drain away through 
them. Fatty degeneration of the kidneys as of other organs is liable 
to take place. From the organic changes which take place in the 
liver and kidneys diabetes may result, as an enormous quantity of 
grape sugar is manufactured by the liver and eliminated by the kid- 
neys. 

The derangements of the nervous system are numerous and prom- 
inent. In the early stages of this trouble the heart is unduly stimu- 
lated and drives too much blood to the brain. The blood vessels of 
the brain are in a condition of chronic congestion. The effect of this 
unnatural blood supply to the brain produces a sense of dullness or 
confusion, headache, varied mental disturbances, disorders of motion 
and sensation. Unnatural noises are sometimes heard, spots and imag- 
inary objects appear before the eyes, buzzing noises are heard in the 
head and cramps and pain in the feet ami legs are not unusual. Sleep 
is disturbed and troubled with dreams and hence fails to bring 
suitable refreshing. Insomnia is sometimes very troublesome. The 
mind is depressed and melancholy and undue irritableness are ex- 
perienced. The nerves are in a state of partial paralysis and the face 



THE NEW MEDICAL WORLD. 107 

and ears are red and congested, owing to the relaxation of the nerves 
which control the blood supply. 

Perspiration is abundant owing to the loss of nerve control over 
the opening of the sweat glands. The eyes are sometimes red, the mus- 
cles are trembling, the pulse at length become feeble, skin clammy, 
tongue coated, voice husky, breathing irregular, heart weak, over- 
worked and more or less used up. The mind loses its vigor, the 
moral sense deteriorates, the conception of duty, honor and justice 
are lost, and crimes are often committed the thought of which would not 
have been entertained for a moment previous to the formation of 
this debasing habit. 

Family obligations are overlooked. Moral energy is lost, physical 
energy is reduced so that the usual occupation is abandoned. Self- 
respect is at last lost if the body has not succumbed to previous or- 
ganic derangements. The memory fails and life is warped in all its 
relations. There is degeneration of the brain and perhaps insanity. 
Asylums contain many alcoholic wrecks. The best way to avoid the 
evils of drink is to wholly abstain from its use. There is no other 
safeguard. Do not trust yourself to use it moderately. Any indul- 
gence is unsafe and prevention is better than cure. 

III.— THE MORPHINE, COCAINE AND CHLORAL HABITS. 

The morphia habit is frequently formed as the result of being 
obliged to take this agent continuously to relieve j^ain i n cases of 
severe injuries, painful growths and affections. Those persons for 
whom morphia has been thus prescribed, often persist in having the 
prescription refilled until they acquire this fascinating habit. It is 
often continued in this way for years after the necessity for its 
administration has ceased. In order to maintain the exhilarating 
effects of this drug, the victim is obliged to increase constantly the 
amount taken, and ere he is aware of it he has become a slave to a 
habit, which becomes persistent and exacting in its demands. 

The prominent effects of using this drug are impaired appetite and 
digestion. The functions of the liver are diminished ; the secretion 
of bile is lessened, and constipation ensues. The lips and tongue are 
dry, because the glandular activity is reduced, the bod}- is more or 
less fevered, the eye is dull, and there are signs of premature old age. 

The most noticeable and pitiable result, however, is the loss of will 
power. This becomes so enfeebled, that it is usual for a person 



108 THE NEW MEDICAL WORLD. 

addicted to this unfortunate habit to resort to every method of 
intrigue and deception in order to gratify the terrible cravings of the 
system for the accustomed stimulating dose. The victim of this 
habit occasionally resolves to break away from its use, but is so des- 
perately wretched and unhappy that the attempt is soon abandoned, 
and the practice of using the drug becomes so fixed, that it is more 
desired than food, clothing, honor, or anything else. Sometimes the 
unfortunate victim of this habit has learned to use it hypodermicallv, 
and practices self-injections with great regularity at short intervals 
and with increasing doses. 

TREATMENT. 

This consists in abandoning the use of the drug, which can be 
accomplished in two ways, either by taking away the drug abruptly 
or gradually. According to the first method the suffering will be 
intense for a short time. The struggle will be terribly severe. The 
patient must have every moral aid, and especial care must be taken 
that the patient is placed where it is impossible to obtain the longed- 
for stimulant. When the habit is of long standing, there are only a 
very few persons who have sufficient will power left to continue such 
a struggle to a successful termination. It is usually necessary to 
place a person addicted to this habit under the full supervision of a 
competent physician, who will supply those efficient sedatives which 
will render the struggle less terrible. A competent attendant or 
-nirse is also* essential, who will keep close watch of the patient and 
give all necessary aid, by strengthening the patient's determination, 
diverting the diseased appetite, cheering up the despairing and 
despondent victim, who will profess to desire either deatli or a dose 
of morphine. 

The second method is by diminishing the dose gradually for a 
period of three or four weeks until it can be omitted altogether, 
without shock to the patient's system, or detriment to his health. 
The Latter method is preferable where the habit is of long standing, 
the dose taken large and the patient's health not robust. The same 
supervision is necessary in either cast 1 until the victory is won. Only 
those who have treated these cases can comprehend the strength ot' 
the appetite and the intense craving for its gratification. Imagine a 
person otherwise healthy, so disconsolate and so distressed for the 
accustomed opiate as to approach you, with a trembling voice, a 



THE NEW MEDICAL WORLD. 109 

haggard countenance, feigned weakness and nausea, and pitifully 
begging you for one more good dose, saying : " I would give my life 
for one dose of morphine." 

There is nothing but the thirst of the drunkard for just one drink 
which can approach this desire for a little more morphine. Where 
the gradual method is pursued the suffering is less severe, but the 
struggle is perhaps of somewhat longer duration. The result in each 
case is the same, however. By combining with the gradual method 
the temporary use of caffeine, Indian hemp, strong coffee, or avena 
sativa, and such other remedies as the patient's condition requires, 
this terrible habit can be broken up with the minimum amount of 
inconvenience, and the patient will bless the day which emancipated 
him from his slavery. 

With respect to cocaine and chloral little need be said. Where 
these drugs have been used until an insatiable craving for them has 
been established their speedy abandonment must be considered. 
Other agents must be used to strengthen and give tone to the shat- 
tered nervous system. Sleep must be induced by natural means. 
Baths, tonics, agreeable occupation of the mind, exercise in the open 
air, healthy food, massage, and a great variety of healthful agents 
can be suggested. The same principle applies in each case, but the 
abandonment of the injurious drug is preeminent. 

IV.— THE EFFECTS OF TOBACCO. 

That the action of tobacco upon the system is hurtful might be in- 
ferred from its effect upon those unaccustomed to its use. It excites 
in such pallor, nausea, vomiting and the condition of marked debility 
and prostration. This is due to the action of nicotine, a powerful 
narcotic poison which it contains. 

If tobacco is the friend of man it certainly does not manifest its 
friendship upon the first introduction. Use however establishes a 
condition of tolerance and familiarity and leads to a more amicable 
condition of affairs. 

Let us inquire concerning some of the more common effects of 
tobacco on the part of those who continue its use habitually. 

It impresses the brain and nervous system and appears to soothe 
this important organ in conditions of weariness and exhaustion. We 
should naturally infer that its long-continued use would impair the 
activity of the brain, which is true. All stimulants produce in health 



110 THE XEW MEDICAL WOULD. 

but a temporary feeling of relief, which is folk, wed by reaction, and 
unless administered in increasing quantity the last state is less toler- 
able than the first; hence the tendency in all habits which involve the 
use of stimulants or narcotics to increase more and more the amount 
and frequency of the dose. 

The habitual use of tobacco affects the taste and relish of food and 
also the appetite. It interferes with digestion and consequently is a 
frequent promoter of dyspepsia. It excites the secretion of the sali- 
vary and other glands of the mouth and throat, reaction follows and 
a dry and irritable condition of the throat is produced, characterized 
by redness and dryness, a condition which is known as smoker's sore 
throat. The most unpleasant action of tobacco is upon the nervous 
system. It is through the nerves that it produces the well-marked 
disturbances of the heart in inveterate smokers. These disturbances 
are palpitation, irregularity of action and in some instances tremor, 
faintness, tits and paralysis. 

The poison is rapidly eliminated from the body and does no per- 
manent harm unless the indulgence is excessive. Tobacco does not 
produce organic trouble of the heart, merely functional disturbance ; 
but in some instances this is very well marked and often so severe as 
to require the abandonment of the habit. Some other minor symp- 
toms to which the use of tobacco occasionally gives rise are ver- 
tigo, impaired hearing and smell. It is agreed that the use of to- 
bacco is especially injurious to the young, causing impaired growth, 
premature development and physical degeneracy. 

The effect of tobacco upon the race as a whole is unfavorable. It 
augments the tendency to nervous troubles and its influence is given 
to the production of a debilitated and inferior progeny. The young 
ought not to acquire the habit of using tobacco and those who have 
acquired a habit of such pronounced detriment should be induced to 
abandon it at once. The odor of tobacco in the clothing and breath 
renders the user especially disagreeable to persons of refinement. 
While it is not so destructive as alcohol, its effects upon the heart and 
nervous system are so unfavorable that its use should be voluntarily 
restricted or abandoned. 



CHAPTER VL 
ACCIDENTS. 



I. — Drowning. II. — Fainting. III. — Burns and Scalds. IV. 
— Lightning Stroke. V. — Sprains and Bruises. VI. — 
Frost Bite. VII. — Bites of Serpents. VIII. — Stings of 
Insects. IX. — Poisoned Wounds. X. — Hemorrhage 
from Wounds, and the Treatment of Wounds in Gen- 
eral. XL — Incised Wounds. XII. — Scalp Wounds. 

L— DROWNING. 

A DROWNING person should be removed from the water as 
speedily as possible, and efforts immediately instituted for 
reviving the patient. Simple rules are more easily remembered 
and applied than others. 

The first thing to do is to drain off the fluid from the lungs and 
stomach. This is accomplished by placing the patient face down- 
wards, the abdomen resting upon a big, hard roll of clothing, for in 
this position the mouth is the lowest point. Pressure is then made 
upon the spine and back to drive out the water from the lungs and 
stomach. Having thoroughly accomplished this, the patient should 
be turned over and artificial respiration performed. Have the same 
roll of cloth or clothing now placed under the back, below the 
shoulders. Begin by placing the hands on each side of the patient's 
chest, then press in the chest walls, increasing the pressure gradually 
as much as the age will permit. Then suddenly relax the pressure, 
wait two or three seconds, and perform the same movement again, 
repeating it ten or twelve times each minute. 

If necessary, draw out the tongue from the mouth, and do not 
abandon the case for some time. A slight gasp should be regarded 
as hopeful, and should be persistently encouraged till breathing has 
been fully established. 

Persons have been revived after remaining in the water several 
minutes, perhaps fifteen or twenty, but in most cases from two to 



112 THE NEW MEDICAL WORLD. 

five is the extent. It is not easy to determine how long a person 
can remain in the water, and yet be revived, as the time depends 
upon the amount of air in the lungs at the time of entering the 
water ; the more air the chest contains, the longer life will be main- 
tained. 

A person falling into the water from a bridge or other elevation 
and being stunned or knocked senseless by the fall, can be revived 
after a longer interval than one who is making an effort to breathe. 

When the rescued patient has been restored, or when breathing 
has been established, put the patient in bed and surround with abun- 
dant warmth, using blankets and hot water bottles freely. Give hot 
drinks, as beef tea, coffee, a teaspoonful of aromatic spirits of 
ammonia, or an ounce or half ounce of brandy and hot water. 

II.— FAINTING. 

This is due to some sudden impression upon the nervous system 
which depresses the heart and for the time being it is so overwhelmed 
that it nearly or quite ceases to contract. At once the brain fails to 
get its accustomed supply of blood and there is a cessation of con- 
sciousness. The breathing is slow or may be suspended. 

Such a condition can last only a short time. If it is long contin- 
ued death results. 

CAUSES. 

The cause of fainting is anything which temporarily arrests the 
action of the heart. It may occur from loss of blood in profuse hem- 
orrhage, excessive emotion, starvation, fear, harrowing sights, blows 
upon the stomach and poisons which depress the heart. 

SYMPTOMS. 

The face becomes deathly pale, the pupils are enlarged, the pulse 
is feeble, the breathing is labored and gasping or apparently ceases. 
( !onscionsness is lost and the muscles of the body are relaxed. These 
symptoms are more or less intensified as the condition of fainting is 
more or less complete. 

TREATMENT. 

It is imperative t<> place the patient upon the back with the head 
low. The dress or clothing about the neck or waist should be loos- 
ened. Ammonia of suitable strength may be applied t<> the nose or 



THE >."EAY MEDICAL WORLD. 113 

a few drops of nitrite of amyl may be inhaled from a handkerchief. 
Cold water may be sprinkled upon the face to incite reaction and 
fresh air should be admitted. Brandy or other stimulants may be ad- 
ministered by the mouth or hypodermically. 

These means usually avail to restore a person who has fainted, but 
when the swoon is profound and threatens to destroy life the electric 
battery may be applied or artificial respiration may be resorted to, 
and brandy with warm milk may be thrown into the bowels by the 
aid of a sj^ringe. The patient must be kept in a reclining posture tilL 
recovery has taken place. 

When the fainting; is due to hemorrhage lift the bleeding limb 
higher than the head and proceed to stop the now of blood as by 
direction given for such an emergency. The head should be placed 
lower than the heart so that what blood remains in the body may be 
used by the brain. If the hemorrhage is uterine lift the foot of the 
bed six or eight inches. 

III.— BURNS AND SCALDS. 

" What wound did ever heal, but by degrees." 

Burns are caused by dry and scalds by moist or liquid heat. The 
amount of injury produced depends upon two factors ; the first is 
the degree or intensity of the heat and the second is the extent of 
surface involved. 

A slight superficial burn or scald involving only a small area of 
surface is a very common injury and one that is comparatively void 
of danger. There is usually only slight redness of the surface of the 
skin with a somewhat persistent, smarting sensation. The appli- 
cation of a soothing lotion gives relief and the injury is soon for- 
gotten. 

Then again the injury may be so deep and extensive as to produce 
death in a short time, and between these two extremes there may be 
every grade of injury. 

In instances of mild injury, only a superficial layer of the skin is 
destroyed, beneath which blisters which fill with serum form, or the 
whole thickness of the true skin may be burned owing to the inten- 
sity of the heat applied. 

In addition to the external injury there may be internal injuries 
from the inhalation of steain, hot smoke or flames. A superficial 
burn which involves a large surface is often far more serious than a 



114 THE NEW MEDICAL WORLD. 

deep burn of only small area. Even a superficial burn or scald dis- 
ables the functions of the skin which are essential to the continuance 
of animal life. 

It is a common rule that when from one-third to one-half of the 
surface of the body is burned or involved in the injury the ease is 
fatal, even though the degree of injury may not be severe. 

The skin is very liberally supplied with nerves' ami for this reason 
a burn or scald of wide area produces that condition of the system 
well-known and recognized by medical men as shock. This is a de- 
pressed condition of the system in which a person may die without 
rallying. 

Severe burns are sometimes followed by ulceration and other serious 
disturbances of the bowels and other internal organs. 

Burns and scalds result from a great variety of causes among 
which are the accidental contact with molten metals, explosions of 
steam, gas and gunpowder, the accidental ignition of cotton garments 
about a stove or range, the falling of children or workmen into tubs. 
tanks or vats of boiling water, hot fat and other liquids too numer- 
ous to mention. 

TREATMENT. 

When the clothes are on fire a person instead of fanning the flames 

by running into the street should lie down and smother the flames 
with a rug, blanket or whatever is within reach. If a second party 
is present he should dash water upon the flaming victim or extinguish 
the flames by means of a shawl or blanket. Success depends upon 

instantaneous action governed by good judgment ami courageous 
methods. 

In removing partially burned clothing from a person exercise much 

care not to remove the injured skin. Blisters should be carefully 
pricked at the lowest point ami their contents allowed to escape with- 
out the removal of the superficial layer of the skin which forms the 
besl covering for the injured surface. 

If the person is suffering from shock a little stimulant may be ap- 
propriately administered ; if from severe pain and anguish morphia 
should be administered hypodermically, for this will relieve the pain 

and al><> stimulate the action of the heart. If the injury i> extensive 
it maybe dressed in sections, one part at a time. Tlie dressing should 
be put on in a warm room or near the life and the parts not necessary 



THE NEW MEDICAL WORLD. 115 

to expose covered by warm blankets. The dressing should seek to 
exclude the air from the injured surface, hence oleaginous dressings 
have been extensively employed. 

A very soothing application for a burn is the following old but 
efficient remedy. It is composed of equal parts of lime water and 
linseed or sweet oil. This may be applied upon lint and covered 
over with a layer of absorbent cotton, carbolized cotton or iodoform 
gauze. For superficial burns this dressing will answer every purpose. 

Another good remedy is carbolized vaseline or oil. One-half a dram 
of carbolic acid to an ounce of vaseline or oil is the proper propor- 
tion to use, but where a very large extent of surface is involved other 
remedies are more suitable, or a less proportion of carbolic acid 
should be used. Iodoform and vaseline make a good dressing. If a 
large extent of surface is involved use less iodoform, as there would 
be danger of too free absorption of this remedy. 

Other valuable formulae for burns are as follows : 

5, Muriate of cocaine five grains 

Oxide of zinc ointment one ounce 

Mix and apply as needed to a burned surface. 

fy Carbolic acid fifteen grains 

Fl. ext. calendula half an ounce 

Olive oil one half pint 

Mix and apply as needed. 

^ Menthol twenty grains 

Muriate of cocaine five grains 

Vaseline one ounce 

Mix and apply as needed. 

All of the above prescriptions are of a high order. 

Deep burns about the neck and joints require much care in the 
healing process to prevent contraction of the skin. 

The modern method of skin grafting is a very flattering method of 
preventing unsightly contractions. This delicate operation requires 
the experience of the surgeon, to render its performance successful, 
and hence it is unnecessary to attempt a description of the process. 



110 THE NEW MKDK AL WORLD. 

By this simple operation large surfaces can be healed in a brief time, 
and unsightly contractions prevented. No discovery of modern 

times yields more uniform and successful results. 

Burns produced by contact with strong acids or other chemicals 
should be treated on the same general principles mentioned. It is 
well t«> bear in mind that the skin of infants ami young persons is 
more easily impressed by the action of heat than that of adults, and 
hence extensive burns or scalds are more liable to prove fatal to such 
patients. In very serious injury from burns the nerves are para- 
lyzed, and ordinarily the degree of pain experienced is less than 
would otherwise be supposed. 

IV.— LIGHTXIXG STROKE. 

A person receiving an accidental electric shock may be rendered 
unconscious temporarily, or if the current is a strong one, instantane- 
ous death may ensue. The shock maybe largely the result of fright. 
When this is the case recovery usually soon takes place. Insensi- 
bility may last for some time, and then be followed by recovery. 
There is often some paralysis of the motor nerves, usually those of 
the lower extremities. There may be loss of some of the special 
>enses, as sight, hearing, taste or smell. If a person is not killed on 
the spot, there is a chance of recovery. 

Sometimes the body is wounded or burned, and such injuries are 
to be treated the same as similar ones from other causes. When 
death results instantly, it is caused by the shock which paralyzes the 
brain. In some cases the blood is found to be coagulated by the 
electrical cm-rent. 

The treatment for those not killed outright is rest and stimulants, 
as ammonia, brandy and other efficient heart tonics. 

V._ SPRAINS AND BRUISES. 

Sprains are often associated with bruises, and hence we shall con- 
sider both subjects under one head. A sprain is the over-stretching 

<>f the muscular and ligamentous tissues. It may be a Blight or 
severe injury, or any grade of injury between the two. 

In some ca^es the ligaments which bind the bones in place may be 

partially or completely ruptured ami the neighboring parts more or 
leas injured and torn. 



the new medical world. 117 

Sometimes, in stepping down from a carriage or step, the whole 
weight is accidentally thrown on to one side of the foot, and the foot 
is turned under. This occasionally occurs in walking over rough 
walks, or from stepping into a hole or upon a stone. The injury 
caused from such a misstep may be so severe as to require several 
weeks for recovery. In this injury the out or inside ligaments of 
the ankle joint are overstrained, and in the worst cases more or less 
ruptured. 

Many sprains are more serious and require a longer time for recov- 
ery than a fractured bone ; hence a bad sprain should not be treated 
as a trivial affair for no one would so regard a broken bone. Some- 
times the sprain or injury of a joint which at first appears to be slight 
will develop) later serious consequences. Cases of hip joint disease 
in children have resulted from an injury which at first was regarded 
as trivial. Sometimes a fracture has been regarded only as a bad 
sprain and then again a si^rain has been treated with splints as a 
fracture. It sometimes requires a large amount of experience to de- 
termine which condition exists. 

The treatment is so important that a correct diagnosis should be 
made. In a sprain, while there is considerable swelling, the parts 
are not misplaced, and motion of the bone can occur without 
crepitus. Crepitus is the name given to the sound, when one piece 
of bone grates upon another, and is a certain indication of fracture. 
More or less weight can be borne upon a sprained joint, although 
movement is painful while upon a fractured limb, as a rule, no weight 
can be borne upon the injured part, neither can its own weight be 
supported without assistance. 



TREATMENT. 

This is all important. Rest must be enjoined for a reasonable 
time, depending upon the degree of injury. Cold applications such 
as alcohol, witch-hazel or ice are preferred by some to check 
the inflammation. Hot fomentations are, however, the best agents 
for reducing the swelling and relieving the pain. These should be 
applied at once and changed and re-applied for the first day with 
persistency to avert the inflammation. Holding the injured joint in 
a hot bath is beneficial. A little aqua ammonia or bicarbonate of 
soda added will increase the elheiencv of this agent. 



lift THE NEW MEDICAL WORLD. 

Hot applications are recommended because they are preferable to 

cold and afford a greater sense of relief. They aid the capillary 
circulation in the tissues and favor the rapid absorption of the extrav- 
asated blood and lymph and consequently reduce the swelling. If 
the lameness and swelling continue for several days the following 
stimulating liniment will assist the process of recovery: 

^, Camphor liniment three ounces 

( hloroform one ounce 

Mix and apply three or four times a day. 

If the parts are much swollen a snug bandage carefully wound 
about the limb will give a comfortable feeling of support, and will 
favor the tedious process of absorption. If the swelling continues 
and becomes chronic in spite of such well directed efforts as have 
been recommended, absorption and recovery will be further aided by 
painting over the injury with the tincture of iodine. It is good 
economy to commit the care of a severe sprain to a competent med- 
ical man, as there may be earnest indications for treatment which it 
is impossible to anticipate, and which, if unobserved and neglected, 
might lead to serious mischief. 

Bruises are the result of an injury, as a blow with some blunt 
agent, as a stick of wood, an axe, or from a fall. At the same time 
other injuries often accompany bruises, as lacerations of the flesh, 
dislocations and fractures. This is often the case in carriage and 
railroad accidents. The effusion of blood which follows a bruise or 
contusion is due to the injury either of the capillary blood vessels or, 
[i — often, to the rupture of a vein or artery. In the Latter case a 
large amount of blood will penetrate the surrounding tissue-. 

In some parts of the body, as about the eye, where the cellular 
tissue is abundant, a bruise is BUCCeeded by a large amount of extrav- 
asated blood. The technical term for a black eye or other extrav- 
asation of blood is ecchymosis. 

TREATMENT. 

The treatment <>t' bruises IS quite Bimple, nature being able in most 

instances to accomplish the cure with but little aid. Whatever the 
treatment, nature must absorb the extravasated blood, which always 
requires time; the discoloration changing in the process from black 



THE NEW MEDICAL WORLD. 119 

or dark purple to green, and finally yellow, gradually fading till it 
reaches the normal color. The process requires about two weeks. 
Simple water dressings, to which alcohol has been added, are service- 
able, so also are hot fomentations. When soreness and symptoms of 
inflammation follow a bruise, equal parts of tincture of arnica and 
tincture of opium will usually afford relief. Slight bruises require 
no treatment, but sometimes the effused blood, when the injury is 
extensive, instead of being absorbed is changed into pus, and sup- 
purations follow the injury. In such cases it is necessary to lance 
the abscess and allow the pus to drain away, and then wash out the 
cavity with carbolic acid water. One dram of the former to a pint 
of the latter, or a solution of corrosive sublimate of suitable strength. 
For ecchymosis about the eye, there is no better application than 
the following : 

ty Muriate of ammonia one dram 

Water one pint 

Mix and apply to a bruised surface on a cloth. 

VI.— FROST BITE. 

This is an injury where the cold has taken a deeper hold than in 
chilblains and is sufficient to arrest the circulation. Frost bite is 
preceded by tingling and numbness. If frost bite of an extremity as 
a toe is prolonged and severe, the death of the part will result. Any 
part which has been frosted or somewhat frozen should not be ex- 
posed to the heat suddenly as there will be an excessive reaction. 
The nerves in their paralyzed condition are unable to control the 
blood supply, the parts will suffer congestion and gangrene or death 
of the frozen portion will ensue. 

Persons who are exposed to severe cold should not give way to a 
desire to sleep or fall into a state of stupor for death will certainly 
follow. 

TREATMENT. 

This must be careful and cautious. Frosted members must be re- 
stored to the normal condition very gradually, neither warm air nor 
warm water nor the heat of a fire should be allowed but the frosted 
parts should be rubbed with a piece of flannel to aid in establishing 
the circulation, previous to which, rubbing with snow or ice water is 
more suitable if the freezing is severe. 



120 THE .NEW MEDICAL WORLD. 

It may be necessary to administer stimulants. Especial care must 
be exercised to see that the return of the temperature is gradual* Re- 
member never to apply heat to a frosted limb. After the circulation 
hag been established warmth may he gradually added and the frosted 
parts should he wrapped in flannel. Portions which slough should 
he treated in the same way as ulcers, burns and other open sores. 

Sometimes the feet are so frozen as to require amputation. In 
these cases a line forms between the living and the dead tissue and 
shows the Burgeon where to draw the knife. In severe climates per- 
sons are sometimes frozen to death. Persons under the influence of 
liquor are often so bereft of judgment as to lie down in the snow or 
upon the frozen earth and if not rescued are found frozen. 

VH.1-BITES OF SEKPEXTS. 

The red viper or copperhead, cobra and rattlesnake are venomous 
and their bites cause convulsions and death. The poison is intro- 
duced into the system in the act of biting'. The bite of the rattle- 
snake is succeeded by pain of a pricking, burning character, which 
becomes more and more intensified. The tissues surrounding the 
bite or injury show the usual symptoms of inflammation, viz : red- 
ness, heat, pain and swelling, ami there is hemorrhage into the sur- 
rounding tissues which causes their discoloration. 

After the system has been inoculated by these poisons, glandular 
enlargements, suppuration and gangrene take place in succession. 
If the amount of poison introduced by the fang of the serpent is 
large great prostration follows, the circulation is checked or stopped 
in the wounded extremity in consequence of the changes which take 
place in the blood and death results with great rapidity. 

Snake bites produce blood poUoning and the action of this poison 

on the nerve centers produces Irritation, prostration and convulsions. 

TREATMENT. 

The treatment needs to be as energetic as possible in order to have a 

chance of success. A few seconds are sufficient for the absorption 

of the poison into the blood ami general system. A Ligature is ad- 
vised to prevent the poison from reaching the circulation and nerve 
'•enters. This ligature must be placed about the injured extremity 
between the Injury and the heart. It must be tight enough to stop 



THE NEW MEDICAL WORLD. 121 

both the arterial and venous circulation ; the venous blood must be 
prevented from returning to the heart from the injured member. 
Then the tissues about' the wound must" be cut away and the whole 
wound thoroughly cauterized by means of strong carbolic acid or a 
stick of nitrate of silver. Then the blood in the wounded extremity 
is withdrawn by puncturing and cupping and in this way the poison 
with the blood is removed before the circulation is again estab- 
lished. In some cases it has been necessary to amputate the limb in 
which the poison is deposited. 

As the j:>oison is harmless when introduced into the stomach it is 
recommended to immediately suck the bite. Stimulants are given 
internally to counteract the depression and the effects of the poison, 
those most used being ammonia, digitalis, whiskey and strychnia. 
The nitrate of strychnia is reported to be an almost infallible remedy, 
failing in only one case out of a hundred. It is used hypodermically 
and repeated every few minutes as the condition of the patient re- 
quires. The hypodermic tablets are made in doses of one-fortieth, 
one-sixtieth and one-eightieth of a grain which are suitable doses- 
One of these is to be dissolved in a teaspoonful or syringe full of 
warm water and injected beneath the skin, watching the effect and 
repeating the dose as often as the patient's condition demands a re- 
newal of the stimulant. Cases of such importance demand all the 
skill of a competent physician as soon as his services can be pro- 
cured. 

YIIL_STI1\ T GS OF INSECTS. 

In temperate regions the stings of insects, unless in large numbers, 
are rarely severe. They sometimes cause in children fever and other 
constitutional disturbances of a mild character. Sometimes a wasp 
or bee stings the tongue, in consequence of being accidentally taken 
into the mouth with fruit. Should this happen there may result a 
rapid and extensive swelling of this organ. It has sometimes been 
necessary to open into the windpipe (tracheotomy) after such an 
accident to prevent suffocation. 

The stings of insects are relieved by the application of an alkali 
as aqua ammonia. 

The sting or bite of some of the tropical insects is more serious 
and is sometimes followed by pain, vomiting, nervous depression and 
other nervous symptoms. 



122 THE NEW MEDICAX World. 

The bite of the mosquito in South America is more poisonous than 
in North America and is sometimes followed by local inflammation 
and ulceration. In Africa and Asia the bite of the scorpion is so ven- 
omous as sometimes to cause death. 

Large spiders are the means of many harrowing stories. They 
are said to have poisoned infants and small children. It is to be 
observed that such occurrences are usually so far away as to render 
verification impossible. The sad story of the death of a child from 
the bite of a poison spider can generally be seen- in the columns of a 
sensational newspaper about once a year or once in six months, and 
if other news items are scarce, as often as every three months. The 
bite of a spider is to some extent poisonous but it is hardly to be be- 
lieved that a spider is venomous enough to destroy even the life of 
an infant. 

TREATMENT. 

The treatment is the same for a spider bite as for that of the scor- 
pion* Aqua ammonia is the best external application. It may be 
combined with olive oil as the latter is also a useful application. 
Menthol liniment is cooling and would be appropriate. 

The principal remedies relied upon for internal treatment are am- 
monia and brandy if there be symptoms of prostration sufficiently 
well marked to require stimulants. 

IX.— POISONED WOUNDS. 

Many of the bites of insects, reptiles, dogs, eats, weasels, squirrel*. 
rats, and other animals are poisonous to a greater or less degree. 
For the most part these wounds heal readily and occasion no special 

inconvenience; there are numerous exceptions, however, to this 
statement. 

Medical students are exposed to the risk of introducing into the 
system poison material from dead bodies. There is especial danger 
of introducing dangerous poison into the body from handling or 
dissecting those persons who have died from puerperal and scarlet 
fevers, diphtheria, glanders, malignant pustule and such like diseases 

of a poisonous character. Kven inhaling the odors from dead bodies 

may Introduce more or less poison into the system, but this is rarely 

followed by anything more serious than nausea, slight malaise, ami 



THE NEW MEDICAL WORLD. 123 

perhaps boils subsequently. Care must be exercised to prevent the 
inoculation of the system with the fluids of horses, cattle and other 
animals that have died from certain malignant diseases. It requires 
but a very slight abrasion for the introduction of poison into the 
system, and it may be so slight as to be imperceptible. 

Those who have been bitten by a dog or other animal are liable to 
become the victims of fear, and to experience in their imagination all 
the horrors depicted in sensational literature. Dog bites, unless 
severe or by rabid dogs, usually heal kindly and are without especial 
danger. 

TREATMENT. 

Wounds made upon the hands in the dissection of dead animals 
should be first cleansed in the following manner : Suck the blood 
from the wound immediately, and then cleanse it by means of an 
antiseptic fluid, as the peroxide of hydrogen or a carbolic acid solu- 
tion. 

If the introduction of dangerous poison is suspected, cauterize the 
wound with the nitrate of silver pencil, or with chloride of zinc. 
Should inflammation follow, apply poultices, and should pus form 
open the abscess early to jjrevent its absorption into the sys- 
tem. After the pus has been thoroughly removed by poultices, 
apply carbolic salve, iodoform ointment or aristol in powder. Indu- 
rated glands may be painted over with the tincture of iodine ; mean- 
time keep the bowels free and the system in a vigorous condition. 

The wounds caused by a dog's bite are to receive the same treat- 
ment as w r ounds from other causes, unless the animal is suffering 
from rabies. (See hemorrhage from wounds in the article upon 
hydrophobia.) 

A wound caused by the bite of a healthy dog should be carefully 
cleansed. For this purpose use a pint of warm water to which has 
been added a teaspoonful of carbolic acid. The carbolized water 
should be prepared in a clean earthern dish. The wound may then 
be cauterized with nitrate of silver if any suspicion exists as to the 
condition of the animal inflicting the wound, but this process will 
somewhat retard the healing process. The wound may then be 
dusted with aristol powder. Gaping wounds should be brought 
together with plasters or stitches, as the nature and extent of the 
wound may require. 



124 



THE NEW MKDK'AI. WulM.I). 



X.— HEMORRHAGE FROM WOUNDS, 

AND THE TREATMENT OP WOUNDS IN 6ENERAX. 

Blood flows from a wound however Blight, and the amount of blood 
does not depend upon the size of the wound but upon the size of the 
vessels injured. The slightest wounds injure some of the capillary 
vessels, but bleeding from the capillaries is not usually attended with 
danger. The blood from a vein is not of a bright scarlet color a^ La 
blood from an artery. When a large vein has been cut blood flows 
from it in a steady stream. Pressure usually controls hemorrhage 
from capillary vessels and veins. If it does not dust upon it some of 
Monsel's salt (ferri subsulphate) which is a powerful styptic. 

When an artery is cut or wounded bloods flows from it with every 
beat of the heart in a spurt or jet. The danger from arterial hem- 
orrhage depends upon the size of the vessel wounded. From the 





This figure shows the arrangement of the 
handkenhief-tourniquet to arrest bleeding 
from a wound below the knee A large pad 

made by folding a towel, or napkin, or roll- This figure shows the manner of employ* 

tag up a woolen stocking, must first be put tag the knotted handkerchief to srresJ 
Into the hollow behind the knee and the blooding from ■ wound of an artery in the 
handkerchief applied over it. left upper extremity. 

large artery of the leg, the femoral, one would lose blood enough to 
produce death in a very short time. A Btrip of stout cloth <t a ban- 
dage can be fastened tightly enOUgfa around a limb to control the 

hemorrhage. This must be placed just above the wound between it 

and the heart. It may be necess ar\ to place a stick under the 



THE NEW MEDICAL WORLD. 125 

bandage and take a twist or turn in it to tighten it enough to stop 
the hemorrhage especially if the blood is flowing from a large wound. 

A rubber bandage, known to medical men as an Esmarch, is the 
best agent for controlling hemorrhage in a limb, but it is not usually 
at hand and so other measures must be used, as prompt action is 
necessary to save life. The only safe way to control a large vessel 
permanently is to pick it up with artery forceps, draw it out of the 
wound sufficiently and tie a ligature tightly about it. A white silk 
thread, doubled and twisted, makes a suitable ligature in an 
emergency. It ought to be disinfected by dipping it into a carbolic 
or other antiseptic solution. It must be drawn tightly enough about 
the exposed vessel to cut through the inner coats which are less 
tough than the outer. This favors the healing process. It is hardly 
to be supposed that anyone will attempt to ligate permanently a 
large vessel unless beyond the reach of medical aid, but it is neces- 
sary to be able to stop a hemorrhage for the time being till profes- 
sional assistance arrives. 

A torn vessel bleeds less freely than a cut one. The author has 
seen persons who have been run over by an engine or car wheel and 
the leg cut or crushed off and almost no hemorrhage follow the ac- 
cident. The tissues are so crushed as to close the ends of the vessel 
and to favor the formation of clots in them. 

Clean cut wounds bleed freely and heal more readily than mangled 
wounds. Such cuts often heal directly by first intention without 
inflammation or pus. When a cut is made through the flesh, con- 
traction especially of the skin takes place and the wound gaps. The 
opposite lips of a cut must be brought close together and kept in 
apposition for a few days ; healing is often rapid and leaves but a 
trifling scar which tends to disappear more and more with the lapse 
of time. 

It is good practice to first examine and cleanse a wound and re- 
move any dirt, foreign substance or shred of clothing. The cleansing 
is by a wash containing a teaspoonful of carbolic acid to each pint 
of hot water or a tablet of corrosive sublimate. 

If pure carbolic acid is warmed and has added to it a small amount 
of glycerine or alcohol, it will keep in a liquid state in all tempera- 
tures and is ready for use at any moment. Antiseptic tablets of 
corrosive sublimate may be used, and are efficient; they may be 
obtained readily, for they are kept by the druggist, and directions 
accompany them. After cleansing a wound thoroughly bring the 



126 



THE ISTEW MEDICAL WORLD. 



opposing parts close together and hold them there with strips of 
adhesive plaster. Plasters do not hold the parts as well as stitches, 
for they usually allow the wound to gap somewhat, so that as good 
results are not secured as by stitches. Any handy person could learn 
to close a wound by seeing a surgeon do it once. 

Stitches should be removed after four or five days, and the parts 
strengthened, so as not to separate, by strips of adhesive plaster put 
on at short intervals. After a wound is brought together by stitches 
or otherwise, a piece of absorbent cotton, upon which some aristol or 
iodoform has been dusted, should be placed over it to seal it from the 
air and render it antiseptic. Iodoform is objectionable on account of 
its disagreeable and persistent odor. 

Over all, tie a piece of muslin or bandage, or put on adhesive strips, 
depending upon the location of the injury. If the above directions 
are closely and carefully followed the results will be satisfactory. 

Warm applications are excellent to improve the circulation and 
hasten the process of recovery. Some wounds require the attend- 
ance of experienced and professional aid, as the symptoms of inflam- 
mation, fever and suppuration are too obscure to be observed and 
properly headed off by the unskilled. 



XI.— INCISED WOUNDS. 

In general the first thing to think of in wounds of this kind, is to 
stop the hemorrhage. This can often be accomplished by the applica- 
tion of cold or hot water, if only 
small vessels have been divided. 
It does some good to elevate the 
wounded part above the rest of 
the body. Arterial hemorrhage, 
when the blood spurts freely, re- 
quires that the vessel should be 
twisted or tied tightly with a piece 
of silk thread, or surgeon's silk. 
The wound should be cleansed 
thoroughly, either with a carbol- 




Method of applying strips of adhesive plas 
ter to a cut or incised wound. 



ized wash 
the acid to 



containing 



a dram of 



a pint of water, or 



else a corrosive sublimate solution 
containing one tablet to a pint or quart of hot water. Plasters 
answer for small superficial wounds upon the surface of the body, 



THE \ I w MEDICAL WORLD. 121 

but for wounds about the scalp, eyes, nose or mouth, stitches hold 
much better than plasters and should be preferred. Stitches about 
the face should be taken near together, and the needle and Bilk 
should both be suitably fine. 

The utmost cleanliness is required in handling all wounds. 

XII.— SCALP WOUNDS. 

The head is much exposed to injuries from blows and tails. ( >wing 
to the hardness of tin- bone beneath, blunt instruments often divide 
the scalp and produce wounds which resemble incised wounds. The 
sealp is very vascular, being abundantly supplied witli blood vessels, 

hence hemorrhage from these wounds is often profuse. It can be 

stopped usually by pressure and the application of cold water. Make 
a compress, dip it in cold water and hold it (irmly over the bleeding 
wound with the hand. 

In treating a wound of the scalp the first thing is to cleanse the 
wound, remove the hair or dirt and wash away the blood clots, for 
no foreign substance must be allowed to remain. 

After cleansing the wound bring the parts into apposition and 
hold them there. Nothing serves this purpose so well as stitches 
from one fourth to one half an inch apart made with good coarse -ilk. 

Water dressings, tint, of arnica and opium, or powdered aristol 
can be applied. Remove the stitches in four or five day-. 



CHAPTER VII. 

GENERAL SUBJECTS PRELIMINARY TO 
THE STUDY OF DISEASE. 



I. — Health axd Disease. II. — The Two Great Types op Dis- 
ease. III. — Temperature ix Disease. IV. — Kissing nsr 
Its Relation to Disease. V. — Bathixo ix Its Relation 
to Disease. VI. — Symptoms of Disease. How to Read 
am) Ixterpret Them. 

I.— HEALTH AND DISEASE. 

THESE are relative terms since they refer to no definite con- 
dition. It is not easy to determine where health ends and dis- 
ease begins because there is no well-defined border line. Health and 
disease are conditions which overlap each other. 

In order to understand disea.se it is necessary first to know what is 
involved in the conditions which we designate health. Health may 
be regarded as that condition in which the various tissues of the 
body are maintained and all the various bodily functions are per- 
formed in a normal manner. Disease is some departure from these 
normal conditions; it may be only slight and temporary or severe, pro- 
gressive and chronic 

So long as all the tissues of the body are maintained unimpaired 
and the numerous functions of all the organs and parts are performed 
in a regular manner, health is preserved. This leads to an inquiry 
concerning the process by which the tissues and functions oi the 
body are maintained. We immediately perceive that the material 
for maintaining every organ ami every function must be derived 
from the blood supply; hence this must be sufficient in quantity and 
quality in order to maintain health. If the blood supply should be 
deficient in quantity nutrition must fail to a greater or less degree and 

either the whole body suffers a diminished nutrition, or if only parts 
then these parts suffer in a more intense manner. This would mean 



THE NEW MEDICAL WORLD. 129 

either a departure from health, with respect to the whole body or the 
parts which feel the force of the reduced blood supply and deficient 
nutrition. 

The quantity of the blood may be sufficient and still be imperfect 
or below the natural standard in its composition. The blood must 
be maintained both in quantity and quality, and constantly reinforced 
from the food by means of the process of digestion and absorption. 
It is easy to see how food, unsuitable in quantity and quality, can 
disorder the digestive apparatus, effect the blood unfavorably and 
produce disease. There may be some imperfection also in the 
process of elaborating the blood, some disorder of the blood making 
functions, even though the food supply is adequate. 

Thus we perceive how easy it is for this delicate bodily machinery 
to fail in some fine adjustment, so that the composition of the blood 
may be changed sufficiently to allow departure from health and 
become the starting point of disease. To preserve health, an abun- 
dant supply of nutritious food is absolutely required. There must be, 
in addition, the inherent ability to convert the food, taken into the 
alimentary canal, into rich, healthy, normal blood. 

The complex process of absorbing out of the food material all the 
fluids and salts required for the maintenance and growth of the vari- 
ous parts of the body must be carried on with precision and success. 
There must not only be digestion, but assimilation, in order to con- 
stantly manufacture within the body a perfect blood supply. Con- 
sider for a moment that over all these complex processes the nervous 
system must preside. Now when you remember that occupations, 
climate, emotions, and a thousand little things may disturb the 
nervous forces, is it any wonder that sickness or departure from 
health is common ? It is by the power, not of the will, but of nerve 
force, largely independent of the will, that the food we eat becomes 
bone and muscle, nerve and brain. 

So complex is the machinery of the human body, which we so 
little consider, and so often misuse and abuse, that the striking 
wonder is, not that it so often fails in its delicate and mvsterious 
work, but that it succeeds so well and with so little of failure. 

There is still another important and interesting thought in connec- 
tion with the function of the blood, which thus far has escaped our 
notice. Xot only must the blood current carry to the reach of every 
part the nourishment sufficient for its growth and maintenance, but 
it must also carry away the waste products, no longer needed. The 



180 THE NEW MEDICAL WORLD. 

blood supply must come to every part richly laded with nutrition, all 
elaborated and ready to be appropriated, and m its place must 
receive debris, which must be transported to some other organ for 
change or excretion. 

If these waste products were not carried by the blood to the lungs 
and other organs to be changed, or to the kidneys ami other organs 
for elimination, the whole body would soon be, overloaded and over- 
whelmed by poisons, and the blood itself would speedily become 
poisoned and unfit to support life. 

In certain diseases this failure of change or elimination becomes a 
serious complication and threatens death. The carbonic acid, the 
uric acid, and many other poisons, the results of the wear and tear of 
the human machine, must be cast out. If they remain, even in small 
amount, they soon disorder the functions of the body and enkindle 
disease. 

How close then are the relations between many things which seem 
at first separate and distinct. Healthy blood and an abundant supply, 
depends upon healthy food and a proper supply, also upon exercise, 
which stimulates muscular action and assists the process of circula- 
tion ; also upon an abundant supply of oxygen to change the impure 
venous into pure arterial blood. This last change takes place in the 
lumrs, every heart-stroke sending the impure venous blood to the 
loners and every breath bringing the oxygen to carrv on the wonder- 
fill change. 

Can we fail when we trace out these complex methods to recog- 
nize the intimate relation which always exists between health, pure 
food, pure air, pure water and exercise; and to observe that a corre- 
spondingly intimate relation must exist between disease, impure food, 
impure air or water and a lack of exercise. 

It took the medical profession ages to learn what now is so simple 

and apparent, that disease is most successfully treated and most effec- 
tually cured by preventing it altogether. The best medical practice 
is the one coming everywhere to the front in the light of hygienic 
revelation. The physician's greatest work is not in administering 
pills but in disseminating such knowledge in regard to food, water, 
an-, exercise, stimulants and various hygienic topics as will keep not 
Only the individual, but the whole human race, in a constant and vig- 
orous state of health. 

The food which we eat may introduce poison and death, or at least 
sickness and functional disturbance; the water which we drink mav 



THE NEW MEDICAL WORLD. 131 

contain germs that will work untold mischief in the human economy; 
the air which we breathe may be contaminated with poisonous gases 
or convey dangerous disease germs into the system. He is our friend 
who helps to eliminate the dangers to health which lurk in our path- 
way, and who assists in providing for the absolute needs of the race, 
healthy foods at a reasonable price, healthy water uncontaminated 
by foul pollutions, and all the requisites of health, contentment and 
happiness. 

II._ THE TWO GREAT TYPES OF DISEASE. 

There are two kinds of disease — -functional and organic. Disease 
is always some departure from the condition of health. It is gener- 
ally caused by some change in the working of nature's great labora- 
tory, or by the alteration of the structure of some organ or organs. 

We will endeavor to explain these two great general classes of 
disease, known as functional and organic. 

When there is simply a temporary disturbance of an organ, causing 
a departure from health, and no alteration has taken place in its 
structural make up, the disease is simply functional. When perma- 
nent change has taken place in the structure of an organ, so that it 
has become contracted, or enlarged, and its tissues are pressed upon, 
causing pain and disease, this is recognized as organic. 

The distinction is a very clear one, if we will only master the 
phraseology which describes it. A headache is often due to inaction 
of the liver ; there is some functional trouble, the liver is not doing 
its customary work. This may be due to the fact that certain 
elements, which are ordinarily eliminated from the system, when its 
functions are normal, failing to be removed, are absorbed into the 
general circulation, and irritate the brain and nerve centers. The 
waste products of the system, which cannot be transformed and 
reused, must be cast out, or eliminated. When this process is inter- 
fered with, and these irritating substances are too long retained, they 
act as poisons, and give rise to a great variety of symptoms, which 
are known under the somewhat indefinite term biliousness. These 
symptoms, sallow complexion, dizziness or vertigo, headache, want of 
ambition, sleepiness, etc., are departures from the condition of health, 
but they are due to no chang'e in the structure of the liver, and hence 
the disease is termed functional. 

Again, a headache may be due to an entirely different cause, some 



VS'2 THE NEW MEDICAL WORLD. 

growth or tumor, may press upon a nerve ; the disturbance in this 
latter case is not functional, but due to some change of structure, and 
hence organic. Tubercles of the lungs, cirrhosis of the liver, fatty 
degeneration of the heart, Bright's disease of the kidneys, these are 
due to organic change in the structure of various organs, and are 
illustrations of what is known as organic disease. ' 

Functional disease, it will be perceived, is much more 'satisfactory 
to treat than organic. The former usually responds quickly to rem- 
edies, while the latter often advances to an unfavorable issue, in spite 
of all remedies. A disturbance of the working or functions of the 
liver can be easily remedied, often without medicine, if the patient 
will abstain from unsuitable foods, and provide rest and favorable 
conditions for recovery, nature herself being able in a little time to 
regulate the disordered functions. Cancer of the liver is a severe 
departure from the health condition ; organic changes have taken 
place in the liver which neither nature nor medicine can cure. The 
latter can only alleviate suffering, prolong life, and render existence 
tolerable. 

People often get a wrong idea about disease conditions. They 
think the medical practitioner should be able to cope with every kind 
of disease. They do not see the distinctions which are apparent to 
the practiced eye. If they are not at once benefited by medicine, 
they are prone to think the doctor at fault ; and they fail to realize 
that the trouble is not from without, but from within, and hence they 
rly from one to another, catching at this and that straw, hoping for 
health and finding none. 

People seem to think that death is to be avoided at all hazards, in 
some way or other, that it is foreign to human conditions, and always 
accidental rather than natural. There is another and more rational 
view of this subject. Death is a natural process, a part of tbe great 
plan. To be born means to die, and the only question i*» when. 
Every beginning, or birth, points to an end, or death. This is true 
in the whole realm of the animal kingdom. It is as much a pro 
of nature to die as to live ; to cease to exist as to begin to exist. 

Scarcely has the new born babe entered upon its life career before 
it musl run the gauntlet of one disease after another; BO that in a 

Very few years half of the whole number are missing. One by one 
the weak and puny fall out by the way, and sometimes tin- most vig- 
orous, too, are CUt Off by disease. The great problem before u^ i> to 

strengthen the w>'ak, to increase their power of resistance, and then 



THE NEW MEDICAL WORLD. 133 

to diminish the diseases that invade our pathway, to prevent disease 
and thus add to longevity. 

Hence, whatever tends to improve the health condition of the 
parent contributes to the living prospects of the child, and whatever 
weakens and reduces the vitality of the parent reduces the health 
prospects of the progeny. Do we not then see how intricate and far- 
reaching are the subjects which we discuss with regard to health and 
disease ? Do we not see how even our most tenable theories must 
be modified to account for a thousand exceptions which may occur 
in a field of work where all is uncertain, owing to a thousand impor- 
tant factors which may not only be obscure, but entirely hidden ? 
To-day a child is born, even from healthy parents, so far as can be 
discovered. It may seem to have every advantage, and its prospects 
of a long life be excellent ; to-morrow it may begin to decline, by 
reason of some undiscovered organic defect. The heart, perhaps, is 
faulty in its structure and proves unable to maintain the circulation 
and the infant dies. 

We must not possess the confidence, that in all cases, death can 
be avoided, but on the other hand, the ratio of deaths can be materi- 
ally diminished. How many little ones are sacrificed every summer 
to artificial feeding? Instead of the healthy and abundant supply 
nature intended, there is the improperly cleansed bottle and the 
unhealthy milk full of poisonous disease germs by the time it reaches 
the child's stomach. Thousands of children die of cholera diseases 
every summer that, under better conditions, might live and perhaps 
run the average course of human existence. This disturbance or 
disease is only functional, and not organic. Its cause is improper 
food and poisoned air during the heated term, and a lack of knowl- 
edge as to the proper care of these little patients. Its ravages are to 
a great extent preventable. 

III.— TEMPERATURE IX DISEASE. 

The temperature of the body in health and sickness did not receive 
very close attention and study until about thirty years ago. 

The recent observations concerning the temperature of the body 
are due to the invention of a little instrument called the fever ther- 
mometer. This is a very convenient, but rather frail, little instru- 
ment, which consists of a graduated glass tube, in which the mercury 
ascends when the bottom part or bulb is exposed to heat. It is very 
useful in the diagnosis of disease, and discloses a lar^e amount of 



134 THE NEW MEDICAL WOULD. 

information concerning fevers, the breaking down of tubercular 
nodules, and the formation of pus in the body, which can be 
obtained in no other way. 

The temperature of the natural body is called the normal tempera- 
ture. It is very nearly the same in all healthy persons, at all seasons 
of the year. The best way to obtain the temperature is by placing 
the bulb containing the mercury under the tongue, where it should 
remain four or live minutes, if accuracy is desired. It is sometimes 
placed in the armpit, or elsewhere, when the patient is unable, from 
any cause, to hold it in the mouth. 

In some high fever stages, it reaches one hundred and five <>r six 
degrees ; but such a temperature indicates severe sickness, and immi- 
nent danger. In acute rheumatism, a temperature of one hundred 
and four is quite alarming, because it indicates some complication, 
especially of the heart valves. In consumption, a temperature of one 
hundred and four degrees indicates rapid waste of tissue and a 
galloping progress of the disease. In typhoid fever the temperature 
rises slowly, and it takes a week or more for it to reach one hundred 
and three or four degrees, or the highest point. When the evening 
temperature in typhoid does not reach above one hundred and three 
degrees it is a mild case, if it reaches a hundred and five degrees it 
is a severe case, and danger threatens ; a hundred and five degrees is 
very high temperature, it rarely goes above this except in fatal 
cases. 

There is considerable difference between the morning and evening 
temperature. The case is not as favorable when the temperature is 
high in the morning. In fevers which pursue the ordinary course 
the temperature goes higher in the evening and falls toward mid- 
night, a process which goes on until morning. When the morning 
temperature is as high or higher than it was in the evening it is a 
sign of some complication, and indicates a severe case. 

In malaria and malarial fevers the temperature reaches its highest 
point i?i a few hours. A person who was well yesterday and who 
has a temperature of one hundred and four to-day has malarial or 
ephemeral fever. It is not typhoid. 

In pneumonia the temperature rises rapidly from one hundred and 

two on the first day, to one hundred and four or five on the second 
and third days. In pneumonia a temperature below one hundred 
and two indicates a very mild case, with but little exudation into the 
air cells, while one hundred ami four Of five indicates a severe attack 



THE NEW MEDICAL AVORLD. 135 

and a large amount of exudation, and in such a case delirium is quite 
likely to be present. 

The temperature rises rather higher in children when sick than in 
adults, owing to the more active processes of the body. Each mother 
ought to be acquainted with the significance of temperature in 
disease. If a child complains of feeling ill and the temperature is 
under one hundred degrees the sickness is slight, while if above a 
hundred the case is important, and becomes more grave as the tem- 
perature ascends. The higher then the temperature goes the sicker 
the child, except in fever which follows malarial chills, when the 
temperature may ascend very rapidly and reach, for a brief time, a 
very high point without much significance. A rise of one degree in 
temperature corresponds to about ten beats of the pulse. 

The temperature is high in scarlet, yellow, typhus and typhoid 
fevers. When the temperature rises above one hundred and five 
degrees the patient is usually in danger, especially if it continues 
elevated to that degree for any considerable period of time. When 
the temperature remains high after the appearance of the rash in 
measles some complication is indicated. 

After an attack of pleurisy a high temperature generally indicates 
the formation of pus in the pleural cavity. After many acute 
diseases, if the temperature continues at one hundred and three or 
four degrees, it either shows that the disease is still active or that 
some complication exists. 

In the condition of collapse, prior to death, the temperature falls 
below the normal. When the temperature falls below ninety degrees 
recovery seldom takes place. A person is sick so long as the tem- 
perature fluctuates or continues above the normal. 

When, after sickness, the temperature falls to the natural point 
and continues there during the entire twenty-four hours it indicates 
that the disease has abated, and complete recovery to health may be 
anticipated. When, during a course of sickness, the temperature 
rises higher in the morning than at night the patient is getting 
worse, but if the decline is in the morning, it should be regarded as 
significant of improvement. 

IV.— KISSING m ITS RELATION TO DISEASE. 

There is no especial objection hygienically to kissing on the part 
of equals, or friends and relatives, nor as the expression of affection 
and love ; but for strangers to force kisses upon infants and small 



130 THE NEW MEDICAL WORLD. 

children, simply because the babies are sweet and the little ones 
cute and attractive, should be condemned as needless, and liable to 
convey to the child, whose ability to resist disease is especially limited, 
certain contagia which may prove fatal. It is also dangerous to kiss 
persons who are sick with certain ailments, and the practice should bo 
restricted as much as possible. 

Many persons are led by a sincere affection to kiss loved ones 
after death ; it should be universally known that no little danger 
attends this practice. A dead body cannot be regarded as a whole- 
some object, for already the process of decomposition has com- 
menced. We need not regard the dead with horror, nor with 
heathenish superstition, for the body is simply the tenement, vacated 
by its occupant, and it is useless to consume our emotions upon a 
dead and decaying body, which is not only destitute of life, but 
which may be capable of conveying to ourselves and others con- 
tagious diseases. Many cases of sickness and death have been traced 
to this revolting custom. Outbreaks of diphtheria have resulted from 
such a cause, and where death has resulted from diphtheria it has 
been found, in one instance at least, necessary to issue orders pro- 
hibiting the practice of kissing the dead. 

V.— BATHING IX ITS RELATION TO DISEASE. 

The frequent bathing of the body is essential to health, but in 
order to get the most decided benefits from the bath good sense is 
essential. In addition, a few common rules may not come amiss to 
the inexperienced. A person should not bathe too soon after a 
hearty meal, but an interval of two hours should occur between it 
and the dinner. A bath may be very injurious to a person who is 
very much fatigued or exhausted. Wait till a reaction has taken 
place. Be careful about taking a bath when the pores of the body 
are open and the vitality has been lowered by free perspiration. In 
such a condition the bath should be quite warm. Do not stay in the 
water after you experience a sense of chilliness. This applies more 
especially to open air bathing. Only the vigorous and strong should 
bathe in the morning before breakfast. Two or three hours after a 
meal is the preferable time. 

A towel bath followed by brisk rubbing of the skin is very refresh- 
ing before retiring iii hot weather. Bathing in the salt sea water is 
apt to be too prolonged and exhausting, if in the company of a Large 



THE NEW MEDICAL WORLD. 187 

number of persons. Bathing in salt water is invigorating and enjoy- 
able if judiciously performed at the proper season, at suitable hours, 
and is not indulged in too extensively. Persons who are indisposed 
may be injured rather than benefited by this vigorous tumble in the 
waves. Young people who bathe in the surf are inclined to remain 
too long in the water. Fifteen or twenty minutes is long enough 
for the most robust, except the water is delightfully warm, when a pro- 
longed stay may be unattended by harm. 

Rubbing the body after the bath is essential, and completes the 
act with the best results, quickening the circulation of the external 
surfaces. Systematic bathing, or the daily sponging over of the 
body, followed by friction with a coarse towel is healthful and exhil- 
arating. The best time to do this is in the morning before dressing. 

VI.— SYMPTOMS OF DISEASE. 

HOW TO READ AND INTERPRET THEM. 

In cases of sickness, one difficulty which confronts the ordinary 
individual is the inability to read and interpret the symptoms of 
disease correctly. No positive diagnosis can be reached except in 
trivial cases without giving considerable attention to this important 
subject. Disease symptoms must be considered collectively, as well 
as singly. Scarlet fever is often ushered in by vomiting, but from 
this symptom alone you cannot infer that you have a case, for it is 
very common in many other affections. It only indicates the begin- 
ning of scarlet fever, where a group of other symptoms point in the 
same direction, otherwise it may suggest an over-loaded stomach, the 
condition of pregnancy or many other varied conditions. 

By going over some of the common and important symptoms of 
disease carefully you will be better able henceforth to determine what 
is the matter with the sick members of your family. 

The Countenance. — The first thing we naturally notice about a 
person is the countenance, and by a sort of intuition we recognize 
the difference between that of health and sickness. The pupils of 
the eyes are dilated in most diseases, but contracted in opium poison- 
ing and in certain affections of the brain. The countenance is pallid 
in anaemia or from loss o,f blood, from fright or after a fall, or other 
severe injury, especially if there exists the condition known as shock. 
The face is pale in cholera morbus, and both pale and anxious in the 



13^ THE NEW MEDICAL WORLD. 

collapse which soon comes on, when timely relief is not obtained. 
There is an anxious look in diseases of the abdomen, and also in 
certain diseases of the heart. The face is pallid and careworn during 
the progress of many chronic diseases. Mania and imbecility make 
their impression upon the countenance. Emaciation appears in addi- 
tion to pallor if the sickness is severe and of long duration. In 
cholera infantum emaciation comes on early. 

In some diseases of the lungs or air passages, when oxygen is not 
obtained in sufficient amount to aerate the blood the face is pallid, 
with a bluish hue (cyanosis), the lips are blue, and there is a pinched 
look about the nose and face. The countenance bears a purple 
aspect in some of the low forms of fever, as typhus. 

In some affections of the liver the face is sallow. This is the case 
in malaria which always involves the liver, and also in dyspepsia. In 
some of the severer affections of the liver the skin is yellow ; this 
yellow hue, known as jaundice, is especially noticeable in the whites 
of the eyes. 

In cancer there is a peculiar waxy, sallow countenance, which is 
characteristic of this malignant disorder. The face is flushed in con- 
gestions, in the early stage of pneumonia and fevers, in apoplexy, 
in poisoning from belladonna, and in the hectic fever which accom- 
panies the progress of consumption. 

The symptoms which appear in the countenance may mislead one 
who is unaccustomed to the peculiarities of an individual. Some 
persons in health have a flushed countenance, while others are pallid 
or sallow, so that these things must have due consideration. A 
single glance often suffices for grasping the symptoms which appear in 
the countenance. With these a close observer has little or no trouble. 

The Tongue. — The next thing is a look at the tongue, which 
presents a great variety of appearances and reveals much about the 
condition of the individual. The natural appearance of the tongue 
is familiar. It is red, moist and slightly coated in the back part of 
the mouth, even in the condition of health. This natural appearance 
docs not continue long after some departure from health. 

In slight ailments the tongue is usually more or less furred over 
with a whitish or yellowish coat. This condition often indicates 
biliousness, indigestion or some temporary disorder i^i the stomach 
and alimentary canal. In typhoid conditions the tongue is brown 
and sometimes so lissured as to bleed. In scarlet fever the tongue 



THE NEW MEDICAL WORLD. 139 

presents a peculiar appearance, known as the strawberry tongue, 
because the little papillae are swollen and look like the seeds on the 
outside of a strawberry. 

In anaemia and malaria the tongue has a peculiar indistinct appear- 
ance and looks as though it was partially bloodless ; this pale appear- 
ance of the tongue is rarely wanting in malaria. After typhoid fever 
the coating peels off and leaves the tongue somewhat raw and very 
red. This condition is known as the beefsteak tongue. 

In the collapse of cholera the tongue is cold and in conditions of 
great weakness or extreme debility the protrusion of the tongue is ac- 
companied by trembling. In apoplexy the tongue when protruded is 
inclined to either the right or left side of the face, the side opposite 
that half of the brain where the pressure exists which causes the 
paralysis. 

The tongue is coated in all acute diseases as pleurisy, pneumonia 
and the various kinds of fever. The degree and extent of this coat- 
ing, its color and the want of moisture make up a variety of sugges- 
tions which practice teaches one to interpret without mistake. 

The Teeth and Gums. — While glancing at the tongue the phy- 
sician also notices the condition of the teeth and gums. These parts 
often require special attention. Decayed teeth are unhealthy and 
they should be cleaned and filled or else removed except in the case 
of the shedding teeth, which should be allowed to remain as long as 
possible to prevent contraction of the jaw. Rapid decay of the teeth 
is often indicative of some constitutional impairment. 

Certain medicines as iron injure the teeth, and when administered 
should be given in such a way as to prevent this unfortunate occur- 
rence. In typhoid fever the teeth and gums are covered with a 
black collection of matter called sordes. This should be washed 
off and vaseline applied to the lips to prevent their cracking and 
scaling. 

A blue line along the gums indicates lead poisoning. An exces- 
sive flow of saliva sometimes indicates mercurial poisoning though 
there are other conditions which also produce this symptom. 

The Saliva and Mouth. — Some medicines, like jaborandi, in- 
crease the flow of saliva, and others, like belladonna, check the 
secretion, rendering the mouth and throat uncomfortably dry. An 
excessive flow of saliva is sometimes troublesome during the period 
of teething, also in pregnancy and other conditions. 



140 THE NEW MEDICAL WORLD. 

The saliva is thick and viscid in catarrhal inflammations and in 
fevers. It is sometimes mixed with purulent matter in protracted 
bronchitis, and rust colored sputa in pneumonia. 

An eroded condition of the mouth sometimes reveals the fact that 
poison has been taken, and the peculiar appearance of the eroded 
membrane indicates to the experienced eye, just what particular 
poison has wrought the mischief. 

Appetite and Taste. — A bitter taste in the mouth usually indi- 
cates dyspepsia or biliousness, and a sour taste indicates an acid 
condition of the stomach, very common in indigestion. A saltish 
taste is noticed in hemorrhage, and a very disagreeable putrid taste 
from the discharge of a quinsy sore throat, when the abscess ruptures, 
or from gangrene of the lungs. 

In most acute diseases the appetite is lost, and it is perverted in 
hysteria, chlorosis, and frequently in pregnancy. It is often exces- 
sive in diabetes, in certain nervous affections, and when worms infest 
the stomach. 

Thirst is a noticeable symptom in fevers, cholera morbus and cholera 
infantum, and in diabetes. 

Dysphagia. — In certain diseases difficulty in swallowing appears 
as a marked symptom. This is the case in inflammation of the ton- 
sils, pharynx or larynx. It is usual in diphtheria, mumps, scarlet fever, 
abscess of the throat or neck, and many other affections which 
attack or infringe upon the tissues in the vicinity of the throat. 

The Odor of the Breath — The odor of the breath will be no- 
ticed in many cases. It is usually offensive in fevers, quinsy and 
diphtheria, sour in indigestion and it has a peculiar sweetish and sickish 
odor in uremia. This is so marked as to be readily observed by one 
who has ever encountered a previous case. The odor of small pox, 
typhus, gout and some other affections is characteristic. In gangrene 
of the lungs it is so offensive as to be almost unbearable, but fortu- 
nately this putrid condition is quite uncommon. 

The Pulse. — You have noticed that when a physician has been 
called to look you over and see what special departure from health is 
giving you trouble about the first thing he appears to do is to place 
his finger upon your wrist, over the radial artery, thus feeling the 
pulse. This is not the result of habit, but because the pulse reveals 
the action of the heart, and at the same time much concerning the 



THE NEW MEDICAL WORLD. 141 

condition of the patient. There are some facts about the heart beat 
and pulse which it is well to know. It is more rapid standing than 
sitting, still more rapid walking than standing, and still more rapid 
running than walking. 

All exercise increases the action and force of the heart. The pulse 
is more rapid after a meal than before, owing to the energy which 
the digestion of food requires. Every thought or emotion of the 
mind correspondingly quickens the action of the heart. All excite- 
ment disturbs more or less the nervous system, and whatever disturbs 
the nerves disturbs the heart's action in a corresponding degree. 

Exercise and thought are healthy and invigorating within certain 
limits, but if too prolonged and carried to excess may lead to depart- 
ure from health. The relation of the mind to the bodily organs is 
intimate almost beyond our comprehension. 

Age reveals great variation in the frequency of the pulse. In 
infancy the pulse is more rapid than in adult life, and this tendency 
is still more marked in old age. There are many individual excep- 
tions to any general rule which could be formulated with reference 
to this subject. It is, however, sufficient for practical purposes to 
know that the pulse rate per minute in infancy is about 120, in child- 
hood from 90 to 100, and in adult age from 70 to 80, the average 
being about 72. In old age the pulse declines from 70 to 60, and in 
some cases to 50, and even 40. 

It is owing to the vigor of their circulation that children enjoy the 
rigors of winter, and the sports of coasting and skating, while old 
people cling to the warm rooms, and complain of the cold, because 
circulation is feeble in proportion as the heart force has declined. 

The average pulse rate in females is greater than in males. This 
increase does not appear to indicate less vigor, but it is nature's 
method of compensation, for as the stroke is less vigorous a greater 
number are probably required to accomplish the same work. The 
more rapid the pulse, usually the less force in each heart beat. 

In the early stages of fevers the pulse is full and bounding, the 
face often Hushed and the eyes congested. The pulse is rapid in the 
acute diseases of childhood, in scarlet fever, pleurisy, pneumonia and 
in typhoid fever. There are, however, exceptions to this rule. In 
diphtheria the poison acting upon the nerve force somewhat para- 
lyzes and retards its activity, and similar conditions exist in malaria, 
bilious fever and other conditions of disease poisoning. 

The pulse is slow in apoplexy or in allied conditions where com- 



142 THE NEW MEDICAL WORLD. 

pression of the brain exists. The pulse is slow in cases of opium or 
lead poisoning. Some persons in health have a slow pulse rate with- 
out other evidence of debility or prostration, hence a slow pulse does 
not of necessity indicate sickness. Irregular pulse is often due to the 
excessive use of tobacco by smokers. Irregularity of the pulse ap- 
pears to be natural to some persons and may exist, without any other 
indication that health is impaired. In these cases some beats are 
more rapid or more energetic than others, a few" rapid beats may 
occur followed by a few which are slower or more full, or a beat may 
be occasionally omitted. A person of ordinary skill is unable to 
judge whether irregular heart action is natural or the result of disease* 
of the brain or the heart itself. Such symptoms are of but little 
practical importance to the individual and to be unconscious of their 
existence prevents anxiety of the mind and is often favorable to the 
continuance of health. 

In nervous diseases the pulse is usually quick or jerky showing an 
excited and disturbed condition of the system. In the last stages of 
fevers and other diseases which are approaching a fatal termination 
the pulse is small and thready and before death it becomes irregular 
and flickering. We see then how important are the suggestions 
which may be gained by placing the fingers upon the wrist. Practice 
and experience render this procedure almost prophetic. 

Respiration. — The character of the breathing and the number of 
respirations each minute are s3miptoms of great importance. Normal 
respiration admits of quite a wide range. The new-born infant 
breathes about forty times a minute, a child five years old breathes 
about twenty-five times a minute while an adult ordinarily breathes 
from fifteen to twenty times each minute ; the average is about 
eighteen for a healthy adult there being about four pulsations of the 
heart during each act of respiration. 

In fevers the breathing is more rapid than normal except in cer- 
tain typhoid conditions when it may be slower, and in profound opium 
poisoning it also becomes very slow or ceases altogether. The breath- 
ing is rapid and shallow in hysteria, it is short and attended with 
severe pain in pleurisy, it is shallow, rapid and painful in pneumonia, 
running up to forty and sometimes sixty a minute. It is obstructed 
and difficult in croup, Labored in asthma, stertorous (snoring) in pro- 
found anaBsthesia, in apoplexy and in the deep Bleep oi inebrity. In 
certain diseases <>t" the heart the respiration is labored and difficult. 



THE NEW MEDICAL WORLD. 143 

Cough. — The act of coughing is common to many diseases of the 
lungs and air passages. It is sometimes of little at other times of 
serious import. The character of the cough often indicates its im- 
portance as a symptom of disease. A dry, hollow or hacking cough 
may be sympathetic or only of nervous origin and without any very 
special significance. In the early stage of bronchitis the cough is 
tight and dry and affords no relief. This is due to the inflammation 
and dry condition of the bronchi ; later however it becomes soft, deep, 
loose and brings up accumulations of thick mucous. 

In the incipient stage of consumption the cough may be merely of 
a hacking, bronchial type, but with the advanced stages of the disease 
it becomes deep and often distressing. 

In spasmodic croup the cough is hoarse and barking, or in ad- 
vanced croup it may have a whistling sound ; favorable symptoms 
are the softening of the cough and the secretions of mucous. In 
pneumonia the cough is shallow and owing to the pain a strenuous 
effort is made to suppress it. In whooping cough the paroxysms are 
characteristic and so familiar as to need no description. 

The peculiar symptom known as hiccough is caused by a spas- 
modic action of the muscular wall which separates the abdomen from 
the thorax known as the diaphragm. It may be the result of exhaus- 
tion or due to indigestion or some nervous disorder. It is very com- 
mon with infants but of little significance. It sometimes indicates the 
approach of death in serious cases and seems to be due to that final 
exhaustion which is relieved only by the calm and stillness which 
ensues. 

Nausea and Vomiting. — These are symptoms of considerable 
importance when weighed in connection with others. They may 
result from many diverse causes as will be seen from the following 
statements. They often occur from indigestible food in the stomach 
especially in children who devour unripe fruits in the summer. They 
occur in inflammation of the muscular lining of the stomach (gastri- 
tis) whether caused by alcoholic drinks or otherwise. 

They are familiar as occurring from sea-sickness, bilious disorders, 
pregnancy, cholera, cholera morbus and cholera infantum. They 
also occur in ulcers and cancers of the stomach, in diseases of the 
brain, in yellow fever, in Bright's disease, in strangulated hernia and 
from medicinal substances and various poisons. The character of 
the vomited matter is often of some value in diagnosis. In bilious 
attack the vomited matter is composed of mucous and bile, in cholera 



144 TIIK NEW MEDICAL WORLD. 

the characteristic ripe- water vomit occurs, in yellow fever the black 
vomit appears, in ulcers of the stomach mucous, lymph and blood are 
vomited; in cancer of the stomach the microscope reveals cancer cells 
in the vomited matter, in strangulated hernia and obstruction of the 
bowels the vomited matter is characteristic and consists of the con- 
tents of the bowels. Vertigo is rarely due to brain disease but 
often to disordered stomach and liver affections of a temporary 
character. 

Pain. — This symptom is often urgent. It must then be inter- 
preted promptly and correctly, and in infants from their only lan- 
guage which is a cry. In general, pain which is relieved by pressure 
is not attended by inflammation. Colic causes pain of this kind 
and affords infants previous to three months of age most of their 
distress. 

One of the difficulties in interpreting this common symptom is dis- 
closed in the fact that pain is not always experienced at the seat of 
the trouble from whence it proceeds. In hip joint disease the pain 
is felt at the knee, in affections of the liver the pain is felt under the 
shoulder blade, in dyspepsia at the place usually described as the pit 
of the stomach, just under or below the sternum. In affections of 
the bladder and ovaries the pain is felt in the limbs and other mem- 
bers and parts, while uterine diseases produce headaches and pain in 
the top of the head. 

Where pain is the product of inflammation there is usually much 
tenderness on pressure. 

Pain may be constant or intermittent; it may be fixed at one point 
or wander about from place to place. The character of the pain aids 
in the act of diagnosis. In pleurisy the pain is located in the side of 
the chest, and is acute, sharp and cutting. In pneumonia it is dull, 
heavy and aching. In dysentery it is twisting and griping in char- 
acter, while in cholera morbus it is attended by cramping. In 
rheumatism the pain is tearing or gnawing, while in neuralgia it is 
shooting and darting in character, now here and now there. 

In an abscess the pain is pulsating, in erysipelas it is smarting and 
burning, in urticaria (nettle rash) it is stinging, in labor it is rhyth- 
mical and tends to bearing down. The pain which attends the 
passage of gall stones extends from the right side under the short 
ribs t»> the center of the abdomen. It is a very m-\ ere, cutting pain ; 
a similar pain, but in a different locality, attends the passage of a 
calculus from the kidneys through the ureter into the bladder. It is 



THE NEW MEDICAL WORLD. 145 

an agonizing, tearing, cutting pain, which requires energetic measures 
to secure relief. 

The position assumed by the patient often throws some light upon 
the diagnosis. Patients suffering from peritonitis lie upon the back 
with the limbs drawn up. This is the position which permits of the 
largest amount of relief from the tenderness and severe pain in the 
abdomen. 

In asthma and in some forms of heart disease the patient is unable 
to lie down, and finds existence more tolerable by sleeping in a 
sitting posture. In the early stages of pleurisy the patient lies on 
the unaffected side, but later, after the effusion of water into the 
chest cavity takes place, changes and lies on the affected side with 
a greater degree of comfort. In some cases of heart enlargement 
and other affections of this important organ, the patient can lie only 
upon the right side. In the pain of colic the patient often finds a 
measure of relief by lying upon the abdomen. 

Hemorrhage. — This is a symptom which requires deliberate judg- 
ment, unless from an injury, where its source is easily recognized, 
and demands prompt action. Hemorrhage from injuries is treated 
elsewhere. In early life hemorrhage from the nose is frequent and 
usually insignificant. For the treatment of serious cases, which 
require plugging, see Chap. XV., Art. V. 

The amount of hemorrhage and the place from which it proceeds 
are alike important. Hemorrhage from the lungs may result from 
congestion caused by defect in the heart's action, or otherwise, or 
from tubercular disease. Hemorrhage from the lungs is frothy and 
bright red, and is brought up into the mouth by the act of coughing; 
if the quantity is large it is followed by corresponding prostration. 
Hemorrhage from the lips or gums is usually unimportant. It may 
come from the throat as the result of an abscess or ulceration. 

That which comes from an ulcer in the stomach is usually dark 
colored and brought up by vomiting. It is never frothy nor bright 
colored. Blood from the nose often escapes into the stomach during 
the sleep of a young person, and is raised on the following morning. 
Hemorrhage from the ear may occur as the result of a fractured 
skull. Hemorrhage from the bowels may indicate dysentery or piles, 
or it may result from ulceration of the bowels in typhoid fever. In 
these cases it is not necessarily fatal unless the amount is larg-e or the 
patient very weak. 



14<5 THE NEW MEDICAL WOULD. 

Such hemorrhage is sometimes concealed and revealed only by a 
post mortem examination. 

Hemorrhage may result from abortion or after natural labor. This 
may be s<> sudden or so copious as to endanger life. The progress 
of a cancer in the stomach, rectum, womb or bladder may produce 
alarming hemorrhage owing to the erosion of- an artery. Blood 
sometimes appears mixed with the urine and may come from the kid- 
iirvs the bladder or the adjacent tissues. Blood may appear in the 
urine from congestion or inflammation of the kidneys or from a stone 
or cyst in the bladder. It has been known to appear in the urine in 
malaria and other diseases. It is sometimes of quite serious import 
in this connection. 

Blood in the urine as a symptom would be likely to mislead per- 
sons who have not had the advantage of professional training and 
experience. It should be borne in mind that some persons manifest 
a peculiar disposition to excessive hemorrhage from the slightest 
causes. 

Delirium. — This symptom is often observed in diseases of chil- 
dren associated with high temperature and does not necessarily im- 
ply an unfavorable condition. It is common in typhoid fever, mala- 
rial fever, meningitis and some other acute affections. 

Coma. — This is a symptom of serious import in the later stages of 
acute diseases. The coma produced by alcohol is recognized by 
smelling the breath and is not generally fatal ; that of opium poison- 
ing is recognized by the contracted condition of the pupils of the eye 
and if profound requires vigorous efforts to prevent a fatal culmina- 
tion. It is of serious import in typhoid and typhus fevers and other 
diseases which are attended by extreme prostration or disintegration 
of the blood corpuscles. The coma of apoplexy or from any injury 
or compression of the brain is generally the certain forerunner of 
death. 

Paralysis. — This may result from a local injury or inflammation 
of a nerve <»r nerves, or from disease of or pressure upon the spina] 

cord or the brain itself. Paralysis of either the right or left side is 
known a> hemiplegia, while paralysis of both lower extremities is 

called paraplegia. 

The Skin. — The skin is usually hot and dry in fevers. In debility, 
prostration and consumption there is a tendency to excessive >we;it- 



THE NEW MEDICAL WORLD. 147 

ing. It is caused by the debilitated condition which it continually 
increases. In many diseases a moist condition of the skin is to be 
regarded as a favorable symptom. The various eruptions of the skin 
and their significance will be found in the chapter on the skin and 
its diseases. 

Constipation. — This usually indicates a torpid condition of the 
muscular coat of the bowels. It is often associated with indigestion 
and sedentary habits. It indicates a deficiency in the secretions of 
the liver and intestinal glands. 

The Eye Symptoms. — The eye symptoms which should be noticed 
in relation to disease are quite numerous. The pupils are dilated in 
many of the common diseases of childhood, also in hydrocephalus, 
apoplexy and from the use of belladonna and other drugs. The pu- 
pils are contracted in inflammation of the retina or brain, in profound 
narcotism by opium and other drugs of its class. In consumption 
the eyes are remarkably bright and lustrous, while in old age and in 
many diseases the eyes are dim and lose their lustre. The arcus 
senilis is a mark of physical degeneracy and of the ravages of age. 
It indicates that the vessels and tissues of the body are losing their 
elasticity and toughness. 

Rolling the eyes from side to side suggests irritation of the brain. 
Inequality of the pupils also indicates disease of the brain. 

In conjunctivitis the membrane about the eye is congested, in 
iritis the light is dreaded, in cataract the lens becomes opaque and 
the center of the eye looks milky. Many other symptoms, such as 
flashes of light, moving spots, double vision, etc., are of special inter- 
est to the expert, but could not be easily explained to those who have 
not made a special study of the eye and its diseases. 

Ear Symptoms. — Ear symptoms are not so numerous. Rino-ino; 
in the ears may occur from large doses of quinine, from congestion 
of the brain, from nervous debility, from twitching of the muscles, 
or from disease of the ear. 

Deafness may result from cold in the head, wax in the ear. from 
typhus or typhoid fevers, also from disease of the ear, throat or brain. 

(Abnormal Products.) — The Urine as a Symptom. — As the 

waste products of the system are extensively eliminated in the urine, 
this secretion becomes prominent in establishing the existence of 
many otherwise obscure and serious disorders. The normal urine is 



148 THE NEW MEDICAL WORLD. 

acid, and when it is found to be alkaline, dyspepsia or some disorder 
of the digestive apparatus may be inferred. The color of ordinary 
urine is amber or straw, marked departure from which suggests 
malaria, jaundice or other disease according as if is colored more or 
less highly with urates, phosphates, bile pigments or blood. The 
specific gravity of the normal urine ranges between 1018 and 1025; 
marked departure from this suggests that it contains either sugar, 
which may appear in large quantities in diabetes, or albumen and 
tube casts, which, if persistent, indicate Bright's disease. 

There are many reliable tests for the various abnormal products 
which are occasionally found in the urine. These are contained in 
special works upon the subject. Inability to pass the urine is called 
strangury, and may be caused by a fly blister, a calculus or stone in 
the bladder, or by paralysis or loss of nervous control. This condi- 
tion is easily relieved by the introduction of a catheter. 

Suppression or failure of the kidneys to secrete urine is a serious 
condition, and if continued for only a few hours leads to uremic 
poisoning, coma, convulsions and death. Unless the uric acid is con- 
stantly eliminated from the system the blood soon becomes poisoned 
by it, the brain is stupefied and life continues but a brief season. 

There are many other symptoms of disease which are discovered 
by the means employed by the skillful physician or expert who calls 
to his aid appliances such as the opthalmoscope, the laryngoscope, 
various specula and the sphygmograph. Such means, however, are 
not of sufficient general interest to warrant their extensive introduc- 
tion in a domestic work. 



Lower lung 
limit 

Lower pleural 
limit 



Diaphragm 



Liver- — "T 



Gall-bladder-" 



Umbilicus J— 



Cazcum 



Peritoneum - 




Heart-cont 



Stomach 



Small 
intestine 



Sigmoid 
flexure 



-Bladder 



Relations of the abdominal viscera. Anterior view. 



Lung \~j--jt~ 



Spleen 

Pleural 
limit 



Descending 
. colon 



Quadrants-—- — /- 
Lumborvm / 

muscle I' 

F 




■~ Diaphragm 



■Liver 



. Kidney 



m -\ Ascending 

|f| I colon 

m--\~--~ Small 
•'ib- ' intestine 

Bit 

i \! 



/ rS{ 




Relations of abdominal viscera. Posterior view. 



CHAPTER VIII. 
ANATOMY AND PHYSIOLOGY, 

INCLUDING THE 

BONES, JOINTS AND MUSCLES. 



I. — Anatomy and Physiology. II. — The Relation of Physi- 
ology to Anatomy. III. — The Anatomy of the Bones. 
IV. — The Bones of the Skull. V. — The Bones of the 
Face. VI. — The Spinal Column. VII. — Injuries of the 
Spine. VIII. — The Bones of the Upper Extremities, 
Chest and Pelvis. IX. — The Bones of the Lower 
Extremities. X. — The Joints. XI. — The Muscles. XII. 
— Nature's Effort to Prevent Injury. XIII. — Frac- 
ture of Bones. XIV. — Dislocations. 

L—ANATOMY AND PHYSIOLOGY. 

AN effort has been made to present the subject of anatomy so 
briefly and interestingly, and so associated with practical 
lessons, that it will be appreciated by every one. The skeleton, or 
framework of this wonderful human machine, known as the body, 
consists of a large variety of connected bones, which support it and 
give it form. 

The human skeleton itself, when brought from the closet, awakens 
unjneasant associations, and is usualty regarded as frightful and 
hideous, yet when covered and draped with the various tissues, as 
the muscles, and rounded out with the adipose deposits, embellished 
with the supple and yielding skin, and filled with animal life, easily 
ranks as the most beautiful work of art, or as the most intricate 
piece of mechanism. 

The bones are developed in cartilaginous tissue, beginning at 
points called the centers of ossification. Bone is one of the hardest 
tissues in the human body, and is composed principally of lime phos- 
phates, various salts and fat. The microscope shows that bone 



A 




The Human Skeleton— Fuont View. 

a, cranial bones ; b, cervical vertebra* ; c, clavicle ; rf, humerus ; e, sacrum ; /, ulna; 
g, carpus ; h, metacarpus ; i, phalanges ; j, femur ; k, tibia ; /, fibula; rn, tarsus ; n, meta- 
tarsus ; o, phalanges ; p, pelvis containing ilium, ischium :m<l pubcs ; 7, radius ; r. lumbar 
vertebnc ;«, sternum. 



THE NEW MEDICAL WORLD. 151 

tissue is not so compact as it appears, for it is traversed by numerous 
canals (the Haversian) which give lodgement to blood vessels and 
numerous nerves. There are over two hundred bones in the human 
body. Some are long, like the bones of the leg; some short, like 
the bones of the hand; and some are flat, like the bones of the 
skull ; while others are of irregular shape, as the vertebrae which 
unite to form the spinal column. 

The bones are connected together at the joints by strong ligaments 
so as to favor all necessary and graceful movements. It is customary 
to begin the study of medicine with the bones, because they are the 
foundation of the body, and without a knowledge of them it would 
be impossible to obtain a correct idea of the relation of other parts. 
It is necessary to learn the name, size, structure and position of 
the bones and their muscular attachments in order to be successful in 
repairing the injuries to which they are frequently subjected in falls 
and various accidents. Hence the medical student must know a 
great many things about the bones, muscles and nerves, which would 
be considered dry and uninteresting to others, and which will have to 
be passed over unnoticed for want of space. 

It is believed that the general reader will not care to spend much 
time in the examination of the joists, rafters, supports and other 
framework of the house we live in and that far more interest will be 
manifested in the externals of this house beautiful, such as the 
clothes we wear, the food we eat, the water we drink, the cause, the 
symptoms and cure of the diseases to which we are subject, how to 
avoid sickness and live long and well. 

To these practical matters it is reasonably expected that the reader 
will give more willing attention than to anatomical subjects. Since 
anatomy is fundamental it will be necessary to introduce just enough 
of it to render the practical portions of this work intelligible and 
direct those who are seeking for further light to the many special 
and scientific works or encyclopedias better calculated to satisfy every 
inquirer. 

II.— THE RELATION OF PHYSIOLOGY TO ANATOMY. 

The relation of physiology to anatomy is worthy of brief notice. 
While anatomy brings to our attention the various parts of the body 
their situation and relation to each other, the structure of each part 
by itself and of the whole combined, it lacks the charm of vitality. 
It presents the body very much like a machine or watch, to be taken 



152 THE NEW MEDICAL WORLD. 

into pieces in order to note carefully each wheel, the relation that 
one bears to another and to the whole. 

Physiology presents the human machine not as a passive mechan- 
ism but as an acting collection of forces. It brings you the watch, 
not taken into pieces but in motion, every wheel moving in its proper 
place. It is thus that physiology studies the human body not as a 
dry skeleton, not a liver preserved in alcohol, but a skeleton clothed 
with beauty and every part animate and performing its own special 
functions. The lungs are breathing, the heart beating, the blood 
circulating, while you take note of the changes that occur during the 
process of its circuit in the kidneys, the liver, the lungs and back 
through the veins to the heart. You do not analyze the blood to see 
what it contains but you study it as it hurries on its way from part 
to part, continually acting and being acted upon. In the same man- 
ner you study the process of digestion ; the food acted upon first by 
the saliva of the mouth, the pepsin secreted by the glands of the 
stomach, the pancreatic fluid, the bile and the intestinal secretions, 
carefully observing every change until it is taken up by the absor- 
bent vessels and conveyed into the circulation. 

The work performed by an organ is called its function, or if more 
than one its functions, but such work could scarcely be inferred from 
the mere examination of an organ. It is important to study as far 
as possible the organ at work and thereby learn what its functions 
are. Because the arteries were empty after death the ancient doctors 
supposed them to be hollow tubes through which air was conveyed. 
If they had studied the arteries in a living animal, full of blood 
moving always on in wave currents as propelled by each beat of the 
heart they would not have made such a mistake. 

NO one now considers that physiology is a subject devoid of interest. 
How interesting it is to learn that every muscular fiber is composed of 
a bundle of smaller fibers and that each one is accompanied by a nerve 
to control its action and another to preside over its blood supply and 
nutrition ; that it may have abundant material for repairing the wastes 
which are constantly taking place in the fierce life struggle which 
causes such a constant wear and tear of this wonderful machine. 

In this work anatomy and physiology will be combined, the one 
adding interest to and complementing the other. Some knowledge 
of these subjects is essential to a proper understanding of disease and 
its intelligent treatment and only so much will be introduced as is 
deemed essential for such purposes. 



THE NEW MEDICAL WORLD. 153 

III.— THE ANATOMY OF THE BONES. 

In life the skeleton supports the weight of the body and gives 
attachment to numerous muscles, which, by contracting and expand- 
ing, admit of a great variety of movements. The bones of the skull 
protect the brain which they surround, and the many nerves which 
radiate from this great center of force. 

The external surface of the bones is covered by a tough, dense 
membrane, which aids in its nourishment, called the periosteum, and 
the great central cavities are lined by another similar membrane. 
The central cavities within the shaft of the long bones contain mar- 
row, or material stored away for their nourishment. The ends of the 
bones are less compact in structure and the central opening is oblit- 
erated. 

The skeleton contains about two hundred distinct bones, as follows : 

In the skull, or cranium, - - - - 8 

In the face, - - - 14 

In the spinal column, including the sacrum and coccyx, - 26 

The ribs, including the hyoid bone and sternum, 26 

The upper extremities, - - - - 64 

The lower extremities, ----- 62 



Total, - - - - - - - 200 

This enumeration does not include the three small bones of each 
ear, nor the teeth. 

IV._THE BONES OF THE SKULL. 

The eight bones of the skull are the frontal, the two parietal, two 
temporal, the occipital, the sphenoid and ethmoid. 

The frontal bone underlies and gives shape to the forehead. It 
has a vertical and a horizontal portion. The former extends upward 
from the ridges above the eyes to its union with the parietal bones 
on the dome of the skull, while the latter forms the roof of the 
orbits, and its inner surface lodges the anterior lobes of the brain. 

The parietal bones extend from the frontal to the occipital, cover- 
ing the center and sides of the dome. They are united in the center 
by the sagittal suture. They are concave on the inside surface and 
grooved by the arteries which lie just within, and they contain vari- 
ous depressions which correspond to the convolutions of the brain. 



lf)4 THE NEW MEDICAL WORLD. 

The temporal bones are more irregular in form. They are situated 
at the sides and base of the skull and contain the openings for the 
external ear. 

The occipital bone forms the back part of the skull and extends 
forward under the base of the brain, where a great opening, the 
foramen magnum, exists, out through which the spinal cord and 
vertebral arteries pass. Its inner surface is concave and contains 
well marked depressions which receive the lower lobes of the brain. 
On the outside surface there are two smooth spots about the size and 
shape of a lima bean, called condyles which articulate with the first 
spinal vertebra or atlas. They are situated one on each side of the 
great opening. The occipital bone gives insertion to a large number 
of muscles, which are used in the various movements of the head. 

The sphenoid bone is noted for its irregular shape. It touches at 
some point every other bone of the cranium and completes the forma- 
tion of the base of the skull. Its shape resembles a bat with out- 
spread wings. It joins all the bones which enter into the formation 
of the vault of the skull and binds them firmly together. 

The ethmoid bone is situated between the orbits at the root of the 
nose. It is irregular in form and very light and spongy in its struc- 
ture. It enters into the formation of the base of the skull and the 
central division of the nose, called the septum. 

At birth these bones are incomplete in development and so sep- 
arated from each other that they allow the edges of one to shut over 
the other, thus diminishing the size of the foetal head in labor. At 
certain points where the bones unite last there is a temporary ab- 
sence of bone. The most prominent of these openings, called fonta- 
nelles, is at the junction of the frontal and parietal bones. It is some- 
times called the "soft spot" or anterior fontanelle and remains open 
for one or two years. The arteries of the brain give a pulsating 
movement to the scalp at this point and in some cases of severe sick- 
ness there is also noticed a marked depression. 

As the osseous development extends these bones of the skull be- 
come joined in irregular lines, containing tooth-like projections called 
sutures, and they are so firmly dovetailed together or interlocked that 
the bones would break rather than separate on the original lines of 
union. These eight bones described above form in adult life a strong 
unyielding cavity which contains the brain. They are composed of 
two layers or plates of bone united by a bridgework of spongy Struc- 
ture called the "diploe." The external plate is thicker and tinner than 



THE NEW MEDICAL WORLD. 155 

the internal. The diploe is traversed by numerous blood vessels 
which carry nourishment to the structures. 

On the outside of the skull there are numerous elevations known 
as prominences or landmarks. At these points there is great thick- 
ness of bone for the purpose of affording protection to the more ex- 
posed parts. On the inside there are various depressions which con- 
form to the lobes of the brain and grooves for the blood vessels which 
bring the ever-needed supply of nourishment. 

There are various small openings through the skull more especially 
in the region of the base for the transmission of numerous vessels 
and nerves. 

The top, sides and back part of the head are covered by the scalp 
and its growth of hair, which is often luxuriant and ornamental. A 
broad and high forehead may indicate intelligence and a low, slop- 
ing forehead the opposite condition, but such indications are not 
always correct. Owing to the firm plates of bone beneath the scalp 
injuries usually extend down to the bone. They bleed freely but if 
properly dressed heal rapidly. 

V.— THE BONES OF THE FACE. 

The bones of the face are fourteen in number, and together with 
the eight of the cranium, already described, make up the complete 
bony framework of the head. There are two nasal, two superior 
maxilla, two lachrymal, two malar, two palate, two inferior turbin- 
ated, the inferior maxillary and the vomer. 

The nasal bones are two small ones forming the sides of the upper 
part of the external nose and uniting in the center to form the bridge. 

The two superior maxillary form, by meeting and uniting in the 
center, the bone of the upper jaw. They are of great interest to 
the surgeon, because of numerous diseases which develop in this 
region. They enter into the formation of the roof of the mouth, the 
sides of the nose, and the floor of the orbits. They contain a cen- 
tral cavity called the antrum of Highmore, and also give firm lodg- 
ment to the upper teeth. 

The lachrymal bones are two very small ones about the size of a 
finger nail, situated near the inner angle of the eye. They assist in 
the formation of the lachrymal groove, which lodges the lachrymal 
sack and also in the formation of the lachrymal canal which lodges 
the nasal duct, hence their name. 



156 



THE NEW MEDICAL WORLD. 



The miliar, or check bones, are two irregular prominent bones 
which are situated one on each side of the face beneath the eye. 
They enter into the formation of the orbits, they join the upper jaw 
bones in front, and contain an area of bone which extends to join 
the temporal bone just in front of the ear. 

The palate bones are of irregular form and situated at the base of 
the cavity of the nose, filling up the vacant space and wedging 
together the other bones so as to complete the framework back of 
the upper jaw. They assist in the formation of the orbits, the nasal 
cavities and the roof of the mouth. 




Bones of the Skull and Face. 
a, frontal ; b, parietal ; c, temporal ; the occipital is behind and out of sight, the sphe- 
noid and ethmoid enter into the formation of the base of the skull and are not visible ; rf, 
nasal ; e, upper maxillary ;/, lachrymal : g, malar ; h, inferior maxillary or lower jaw. 

The turbinated bones consist of a thin layer of bone rolled upon 
itself like a scroll and hence the name. They are situated on each 
side of the nasal cavities and assist in their formation. 

The vomer forms a part of the partition in the center of the nose, 
and is placed vertically. It receives its name from its resemblance to 
a, ploughshare. 

The inferior maxilla is the only movable bone of the face. The 
main or horizontal portion of the bone is semicircular in form, and 
shaped like a horseshoe. It gives lodgment to the lower teeth. On 



THE NEW MEDICAL WORLD. 157 

each side is an upright portion which extends upward to form a joint 
in front of the ear ; in front of the joint is a projection of bone which 
gives attachment to the temporal muscle. Other powerful muscles, 
the masseter and buccinator, are attached to this bone for the pur- 
pose of moving the jaw in biting and in the mastication of food. 

At the base of the tongue is found a small bone, the hyoid or 
lingual, which gives support to this organ, and to which also are 
attached many delicate little muscles so numerous in this region. It 
is shaped like a horseshoe. It is not joined to any other bone, and 
exists simply to increase muscular attachments. 

The head in man is the most prominent part of the body. It is 
made up of a large number of tissues, the most abundant of which is 
the brain within the skull. This, together with the cranial nerves, is 
reserved for separate consideration. We have seen that the frame- 
work of the head is made up of twenty-two bones. External to this 
bony framework are numerous muscles, vessels, nerves and associate 
tissues. The muscles of the face are numerous, and cause varied 
expressions which indicate fear and boldness, despair and hope, 
pleasure and pain, joy and grief, innocence and guilt, disgust, con- 
tempt and trouble. 

Hence the face is that portion of the body which gleams with in- 
telligence and is properly admired for its beauty. It becomes im- 
pressed with the habits of thought and the occupations of life and 
reveals in a tell-tale way otherwise hidden secrets. Phrenology 
is of trifling importance in indicating the character of a person 
by the external contour of the skull, but the demeanor, the general 
expressions of the face, the tones of the voice, these together form 
an array of data from which many true deductions can be made. 
Persons of large business capacity or those who have the reputation 
for great firmness or those who have been • the recipients of many 
honors are apt to disclose without effort or intention these individual 
traits. Those accustomed to authority for a long time carry the head 
more erect until the spine becomes unyielding, the face assumes firm- 
ness and the voice becomes commanding. These are the pointers 
which unconsciously disclose what phrenologists profess to find in the 
elevations and depressions which exist on the outer plate of the skull. 

VI._ THE SPINAL COLUMN. 

The spinal column is made up of twenty-six bones, twenty-four 
vertebra?, with the sacrum and coccyx. There are seven cervical 



158 



THE NEW MEDICAL WORLD. 



vertebrae, twelve dorsal ami five lumbar. The sacrum is formed 
from what were originally five vertebrae, and the coccyx from four. 

The vertebra are piled into a col- 
umn like empty spools upon a string, 
one resting upon another. This col- 
umn supports the head. Behind the 
body of each vertebra? there is an open- 
ing which, with the others, similarly 
situated, forms a canal through which 
the spinal cord and its membrane pass 
from the brain, giving off branches on 
the way which reach every portion of 
the body. 

Between the bodies of the vertebrae 
there is an elastic cushion so as to lessen 
jars in walking or running and prevent 
weariness from standing or other bodily 
exercise. The vertebrae are bound to- 
gether strongly by ligaments, and the 
strong processes of bone so interlock 
that it requires a severe fall or injury to 
separate or displace them. 

The upper, or cervical, is called the 
atlas. It supports the head, and joins 
the occipital bone of the skull. It is of 
peculiar shape, the body being absent. 
The occipital bone is so articulated with 
the atlas as to allow of nodding motion, 
and of throwing the head backwards. 
The second cervical vertebrae is called 
the axis, because it has a large tooth-like 
process which fits into the atlas. When 
the head turns or rotates this tooth-like 
proce^> acts as a pivot and rotary mo- 
tion thus takes place between the atlas 
and the axis. 

The vertebra- are heavier in the dor- 
sal than in the cervical region, and still 
heavier as we go downward. When the lumbar region is reached 
the vertebrae are very strong, thick ami heavy. This is necessary to 




The bones of the spinal column 
as seen from the left side. The 
numbers refer to the vertebrae of 
the different regions. 

a, cervical vertebra? ; b, dorsal 
vertebra? : c, lumbar vertebrae ; d, 
sacrum ; «, coccyx. 



THE NEW MEDICAL WORLD. 159 

support the increasing weight of the body. The vertebrae give attach- 
ment to many muscles which control the movements in the spinal 
region. 

VTL— INJURIES OF THE SPINE. 

When a person falls a considerable distance from a tree or build- 
ing the spinal column is sometimes dislocated or fractured and the 
cord in either case may be seriously injured. In these accidents 
there is paralysis of the body below the point of injury. 

When such injury is in the upper region of the neck the upper 
limbs are paralyzed and the sufferer usually lives only a short time. 
The result of spinal injury varies and depends upon the amount of 
damage done to the spinal cord or marrow. When this is severe the 
cord being crushed, if the patient survives his condition is pitiable. 
Many of these cases terminate fatally as the result of inflammation 
and softening of the cord. 

The spine may be sprained and the ligaments which bind the adja- 
cent vertebra? together lacerated and yet the cord escape serious 
injury. When portions of the vertebra? are crushed a severe injury 
is indicated. The adjacent vertebra? may be dislocated. This pro- 
duces pressure upon the cord and at least temporary paralysis of all 
the body below. The injury is recognized by a break in the conti- 
nuity of the spinous processes which may be felt by running the lin- 
gers of the hand down the back. The treatment must be prompt. 

Place the injured man upon his abdomen. Powerful extension 

must be made by four men. two at the upper and two at the lower 

extremities while the surgeon pushes the displaced vertebra? back 

into place. If this is well done and the cord is not severely injured 

1 recovery may be expected. 

The gravity of the case depends upon the amount of damage t- x- 
perienced by the cord. Spinal injury may result in temporary or 
permanent paralysis, hemorrhage or the effusion of fluid into the 
canal about the cord, inflammation of the cord and its membranes, 
and lastly softening of the cord which would be followed by hopeless 
paralysis. These uncertain and serious results are liable to follow an 
injury of the spine. 

It must not be forgotten that any considerable injury to the spine 
renders it impossible to empty the bladder and the water must be 
drawn frequently by a suitable catheter. Spinal injuries ought to 
receive prompt surgical attendance. 



160 THE >'EW MEDICAL WORLD. 

VIII.— THE BONES OF THE UPPER EXTREMITIES 
CHEST AND PELVIS. 

The scapula, or shoulder blade, is a large, flat, triangular shaped 
hone situated back of the shoulder. It is held in position by large 
muscles. At the upper, outer end it has a cup-shaped depression in 
which the upper end of the humerus rotates, forming a ball and 
socket joint. The scapula is quite thin ; a large spine or brace of 
bone crosses the upper third and teminates in a projection, the 
acromion process, which helps in the formation of the cavity of the 
shoulder joint. There is still another projection of bone, the cora- 
coid process, which also enters into the formation of the joint. 
Large and powerful muscles are attached to the sides and edges of 
this bone, some of which extend to the humerus and assist in the 
movements of the arm. 

The clavicle, or collar bone, is a long bone curved like the italic 
letter »S. It is situated at the top and front part of the chest above 
the ribs. It extends from the upper outside corner of the sternum 
to the acromion process of the scapula. It is a brace to hold the 
shoulder back in place, and its curved direction renders it more 
clastic, and less liable to fracture when one falls upon the shoulder. 
Notwithstanding this fact it is often broken, especially in childhood. 
Several muscles are attached to this bone, some of which aid in the 
movements of the head. 

The humerus is a long and powerful bone situated in the upper 
arm and extending from the shoulder to the elbow. The upper end 
is a rounded head which tits into the socket of the scapula. This cup 
or socket is rendered deep and complete by surrounding tissues so 
that the head of the humerus rotates in every direction. The humerus 
has numerous powerful muscular attachments, large muscles coming 
from the front and back of the chest and top of the shoulder so as to 
secure a great variety of motion. 

The bones of the forearm are the radius and ulna. When the 
hand is placed on its back these two bones are parallel, the radius 
occupying the outside portion. When the hand is turned over onto 
the palm the radius crosses the ulna obliquely. The upper head of 
the radius rolls upon the ulna. The ulna is large at the elbow and 
forms the principal part of the joint. The point of the elbow called 
tlic crazy bone is a projection from the ulna. Its true name is the 
olecranon process to which the triceps is attached, a strong muscle 

which straightens the arm. 



THE NEW MEDICAL WORLD. 161 

At the wrist the radius is large and enters into the formation of the 
wrist joint. When one falls upon the hand the radius is often frac- 
tured near the wrist. This fracture is called a Colles fracture and is 
one of the most common injuries which the surgeon is called to treat. 
Many powerful muscles are attached to these bones which become 
tendons or cords as they approach the hand. 

The wrist consists of eight bones arranged in two layer or rows 
and strongly bound together but capable of some slight movement, 
and hence of increasing the elasticity of the hand. The names of 
these are the scaphoid, semilunar, cuneiform, pisiform, trapezium, 
trapezoid, os-magnum and unciform. The bones of the thick portion 
of the hand are the metacarpal ; they are live in number and they 
may be felt beneath the skin on the back of the hand. Four of them 
are parallel but the one belonging to the thumb stands out consider- 
ably from the rest. 

The bones of the fingers are called the phalanges. There are 
fourteen in each hand three in each linger and two in each thumb. 
The lingers are manipulated chiefly by tendons which are the contin- 
uation of muscles of the arm. 

The sternum is a flat bone in the front part of the chest. It is 
made up of three bones which become united into one in adult life. 
On each side it is joined by the clavicles and by the cartilages of the 
ribs. 

The ribs are twenty-four in number, twelve on each side. They 
are long curved bones extending from the spine around to the ster- 
num, forming the chest cavity which contains the heart and lungs. 

The union with the sternum is cartilaginous. The first rib is short 
and crooked. The two lower ribs are not joined to anything in front 
and hence are called floating ribs. 

The thorax, or chest, is the cavity bounded by the spine, ribs and 
sternum, and on the under side it is separated from the abdominal 
cavity by a muscular partition called the diaphragm. The ribs are 
so constructed that they rise and fall during every act of respiration, 
and thus increase and diminish the capacity of the chest alternately. 

The abdominal cavity lies below the diaphragm and extends to the 
pelvic basin. It lies in front of the large lumbar vertebrae. There 
are no bones in front, but strong muscular walls. Within the abdom- 
inal cavity are the liver, stomach, pancreas, bowels and kidneys. 

The pelvic cavity or basin is surrounded by strong bones, the 
sacrum is behind and on the sides and front are two large, broad, 



BONES OF THE THORAX AND UPPER EXTREMITIES. 





The Scapula. 

a, acromion process ; 6, coracoid process ; c, spine of 
scapula ; d, lower angle. 



Sternum. 

The ribs are illustrated 
on a previous page. 





Hi mi:iiU8. Radius. 



Ux.HA. a, K bones of wrist ; 6. metacarpus 

162 c, d, «, phalanges. 



THE NEW MEDICAL WORLD. 



163 



flaring bones, and from their lack of resemblance to anything they 
are called the nameless bones (innominata), and they are sometimes 
called the haunch bones. The os innominatum in early life is com- 
posed of three bones, the ilium, ischium and pubic ; these unite in 
adult life and form one bone. 

The sacrum fits in between the innominata like a wedge. The 
ilium is the upper and flaring portion of the os innominatum, usually 
called the hip bone ; the ischium is the lower portion, upon which the 
body rests when we sit. The rim of bone running round in front to 
meet its opposite is the pubic bone, and the line of union is called 
the symphysis. On each side there is a deep cup- shaped depression 
to receive the head of the thigh bone, or femur. This deep cup is 
called the acetabulum, and the thigh bone is held in it by a strong 



a- 



_ a 




The Pelvic Cavity or Basin. 
a, nameless bones (innominata) ; b, acetabulum ; c, sacrum. 

ligament, the ligamentum teres. The sacrum and innominata form 
the pelvis. Within the pelvis are important organs, as the bladder, 
the uterus and the rectum. 

The pelvis is of especial interest to the physician, who must under- 
stand thoroughly its mechanism in order to be successful in conduct- 
ing difficult labor or childbirth. 

IX.— THE BOXES OF THE LOWER EXTREMITIES. 

The femur or thigh bone is the largest, longest and strongest bone 
of the human body. Its upper end terminates in a rounded head 
which rolls in a deep ball socket joint and permits of motion in sev- 
eral directions. 



104 THE NEW MEDICAL VVOBLD. 

The head joins the main shaft almost at right angles. Powerful 
muscles from the pelvis are attached to this bone to carry out the 
movements necessary in walking and other varieties of exercise. The 
bone enlarges at its lower end to form the knee joint and the two 
projections are called condyles, one outer and the other the inner. 
The inner condyle is the larger of the two, and between the two con- 
dyles is a notch which is filled with a corresponding elevation at the 
summit of the head of the tibia. 

The patella or knee cap covering the outer portion of the knee 
joint is a flat triangular one. It lies directly over the knee joint in 
front and is held in place by the quadriceps extensor muscle to which 
it gives attachment. When the leg is held in a straight position this 
powerful muscle is relaxed and then the bone can be moved about quite 
freely with the hand. It protects the knee joint which is much exposed 
to injuries ami increases the leverage of the muscles attached to it. 

The tibia is the large and prominent bone of the leg situated on the 
inner side of the leg. It ranks in size and length next to the femur 
and is the next largest bone in the skeleton. It is often called the 
shin bone. Its front portion lies just underneath the skin and super- 
ficial tissues and its outline may be seen by the eye or felt by the 
hand. Its ends are enlarged to form a portion of the ankle and knee 
joints. On the inside the bone projects down over the ankle and 
this projection is called the malleolus. 

Parallel with the tibia is a long, slender, small bone of equal length 
called the fibula or splint. Its upper end does not enter into the 
formation of the joint but rests against the tibia. The lower end of 
this bone projects down over the ankle joint on the outside and is the 
outer malleolus. Fracture of this bone is often unrecognized from 
the fact that it is so enveloped in strong muscles that it can only be 
felt for a few inches above the ankle. Its chief importance i> to af- 
ford attachment for the muscles of the leg and assist in forming the 

ankle joints. 

The ankle bones are seven in number, the calcis, astragalus, cuboid, 
scaphoid, internal, middle and external cuneiform. These bones of 
the ankle together are called the tarsus, and are one less in number 
than the bones of the wrist, or carpus. Their arrangment is some- 
what different. The os calcis forms the heel and is the Largest <>\ 
these bones. To it is attached a powerful tendon, the. Achilles a 

Continuation of the muscles of the calf, which raises the body upon 
the front of the foot in w :'lkiiiL r . 



THE NEW MEDICAL WORLD. 



165 



The astragalus forms with the lower end of the tibia and fibula the 
ankle joint. It rests upon the forward end of the os calcis. In front 
of the astragalus on the inner side of the foot is situated the scaph- 
oid, while on the outside of the foot is situated the cuboid bone. 

BONES OF THE LOWER EXTREMITIES. 




a 



b 



- € 



:d 

e 

Femctr. Fibula. Tibia. Foot. 

a, tarsus ; b, metatarsus ; 
c, d, e, phalanges ' 

The cuneiform are arranged in a row of three bones wedged in 
between the scaphoid, cuboid and metatarsal bones (see plate). The 
metatarsal bones are live in number and extend forward from the 
bones of the tarsus toward' each toe. 

The phalanges like those of the hand are three in number, except 



166 THE NEW MEDICAL WORLD. 

for the great toe, which, like the thumb, has only two. This brief 
description completes the bony framework of the human body; this 
framework gives to it form, and also gives attachment to a great 
variety of muscles which are essential to motion. 

X.— THE JOINTS. 

X early every bone is connected with one or more others to form a 
joint ~<r articulation, which admits of varying degrees of motion to 
correspond to the requirements of the particular region. Indeed, 
some of the articulations are immovable, the bones being united so 
firmly in adult life as to admit of no motion. The articulation of the 
cranial bones are immovable, and are called sutures. 

In some, only slight motion is required, and such articulations are 
bound together by tough, elastic fibers and cartilage, as for instance 
the vertebrae of the spine. In others the ends of the bones are 
enlarged and free motion in one direction takes place, as in the elbow 
and knee, which are hinge joints. 

In still others there is greater freedom of motion, and the rounded 
head of the bone rotates in a deep depression or cup, as the shoulder 
and hip joints. These are known as ball and socket joints and admit 
of the freest motion of all the joints. 

The ends of bones forming movable joints are covered over with a 
smooth layer of shining cartilage and bound together by ligaments, 
which are composed of strong, tough, elastic fibers. Around the 
movable joints is a thin, delicate membrane, the synovial, which 
secretes a thick, viscid fluid, resembling the white of an egg; this 
keeps the joint lubricated. Without this jointed arrangement of the 
bones the body would be stiff, unyielding and lacking in graceful 
movement. It would be impossible to sit down, to lie down, or turn 
either the head or body. A joint capable of motion in all directions 
is a ball and socket, while a joint limited to two motions, forward 
and backward, is a hinge joint; the elbow, knee and ankle are 
specimens of the latter. 

XI.— THE MUSCLES. 

The bones themselves have no power of motion except as they arc 

acted upon by the muscles. Muscles possess the power oi contract- 
ing when acted upon by nervous stimulus. In some muscular tissue 

the nerve force generated by the will causes contraction ; in other 



THE NEW MEDICAL WORLD. 167 

tissue the stimulus is developed independently of the will power as it 
is necessary to keep up organic action in the digestion of food and 
during sleep. 

There are found to be two kinds of muscular fiber ; voluntary, or 
those controlled by the will, also known as striped muscular fibers or 
the muscles of animal life ; and involuntary or those acting independ- 
ently of the will, also known as unstriped muscular fiber or the mus- 
cles of organic life. 

The muscles are composed of bundles of libers held together and 
enclosed by a delicate tissue. Each bundle is composed of groups of 
smaller bundles and each little bundle can be separated into primitive 
fibers smaller in diameter than an ordinary hair. 

The voluntary muscles composed of masses of fibers surround the 
bones and make up a large portion of the external weight of the 
body. Many of them are attached to the bones and by contracting 
cause the various movements of the body, as in walking and all 
kinds of manual labor. The blood supply to the muscles is abundant 
by means of the arterial and capillary circulation ; and the nerve sup- 
ply results from a profuse distribution of nerve fibers to the voluntary 
muscles. 

There are several hundred muscles in the human body. They are 
attached to the bones, cartilages, ligaments and also to the skin. 
They vary greatly in size and form and in the manner in which their 
fibers are arranged. In books of anatomy the origin of a muscle 
refers to its more fixed attachment and the insertion to the more 
movable end or point ; this distinction however is often arbitrary as 
most muscles act from either extremity. A knowledge of the action 
of the muscles is important to the surgeon and explains the cause of 
displacements in fractures and other deformities and simplifies the 
methods of treatment. 

Some of the muscles are a guide to the course of important blood 
vessels and stand out as prominent landmarks of the body. The 
muscles have been named without reference to any particular system, 
some from their situation as the pectoral, temporal and gluteal 
others from their direction as the rectus capitis, rectus femoris, etc. 
others from their use as the masseter and the extensors and flexors 
others from their shape as the trapezius, rhomboid and deltoid 
others from some peculiarity of formation as the biceps and triceps, 
and still others from their origin and insertion as the sterno-cleido- 
mastoid and the sterno-thyroid. 



168 THE NEW MKDK'AL WORLD. 

It is necessary that one set of muscles should act in an opposite 
direction to another set; for instance those which bend the forearm 
are called flexors and those which straighten it again extensors. 
Such groups of muscles are termed antagonists. The muscles which 
close the jaw in eating must be antagonized by another set to open it. 

The action of nearly every muscle in the body is antagonized by 
the action of some other muscle in order to produce motion in an 
opposite direction and establish an equilibrium. The muscles which 
move the eye ball form an interesting group, consisting of four recti 
muscles and the superior and inferior oblique. 

The muscles of the arm form an important and interesting group. 
The deltoid rounds out the upper part of the arm, and when con- 
tracted lifts it away from the side of the body. The biceps, aided 
by the brachialis, flexes the forearm and hand, bending the elbow, as 
when a dumb-bell or weight is raised by the hand. 

The triceps antagonizes the biceps and extends the forearm. The 
latissimus dorsi is a strong muscle of the back inserted into the 
humerus, or upper part of the arm. Its action carries the extended 
arm backwards. This muscle is antagonized by the pectoralis, a 
large muscle covering the upper part of the chest and inserted into 
the humerus, which brings the extended arm forward toward the 
chest. From the inside of the lower portion of the humerus, called the 
inner condyle, arise a group of muscles which bend the wrist and 
fingers, and to the outside, the external condyle, are attached the 
extensors, which straighten the fingers and hand, thus antagonizing 
the flexors. 

.Many other things could be said concerning the muscles, which 
would be of interest to those possessing professional or technical 
knowledge, but for general purposes the subject is too complicated 
for more extended consideration. 

XII.— NATURE'S EFFORT TO PREVENT INJURY. 

In connection with a study of the bone8, it is well to notice nature's 

efforts to prevent injury. Nature possesses a great variety of means 
both for warding off injury and preventing disease. We have Been 
how Strong and thick the bones of the skull are in order to thor- 
oughly protect the soft tissues enclosed within. Notice the prominent 

ridges of strong projecting bone which surround the eyeballs to pro- 
tect them from injury. 



169 




The Muscles. 

», deltoid ; b. brachialis ; c, biceps ; d, pectoralis ; e, latissimus dorsi ; /, triceps ; g, gluteus ; 

h, gastrocnemius. 



170 THE NEW MEDICAL WORLD. 

Sec the sensitive eyelids guarded by a row of long hairs along the 
margins to announce danger and close up the eyes so that dust and 
other injurious substances cannot enter. 

Notice the act of vomiting, nature's process to expel disturbing 
substances and poisons. When mucous or foreign bodies occupy the 
nasal passages and the bronchi of the lungs, nature causes you to 
cough or sneeze violently in order to expel the irritating and harmful 
substance. When heat or exhaustion causes the bodily temperature 
to rise above the normal nature gradually opens more than two 
millions of little pores, by which she increases the process of evapora- 
tion, equalizes the temperature and prevents the heat from working 
injury, and at the same time that this evaporation is going on she 
takes occasion to send out noxious elements from the blood, which 
would have to be eliminated in other ways, or else remain to poison 
the system. 

Did you ever think what a complex machine the human body 
is, and what a variety of processes are going on all the time 
within it? 

Have you ever thought how when you climb a mountain and the 
air becomes more and more rarefied and nature requires an increased 
amount of oxygen to keep the machinery running smoothly, that the 
response to her call comes in more rapid breathing ? 

Suppose you are obliged to suffer hunger being allowed only 
short rations. Have you ever considered the resources of this won- 
derful something which we call nature, how she slowly and cautiously 
consumes the surplus fat laid up in the tissues, drawing upon her 
reserve very much as you draw upon your surplus in the bank under 
the force of necessity ? 

Suppose for any reason you are obliged to encounter exposure and 
severe cold, can nature again come to your rescue? Her resources 
are legion ; she closes up the pores of your skin to prevent evapora- 
tion and the escape of heat and sends word to the kidneys that they 
must carry off the waste products which are eliminated ordinarily 
with the perspiration. In addition to this she consumes more of the 
reserve fat and takes in more oxygen into the lungs. 

What happens when we overtax nature and she is unable to 
meet all the demands we make upon her? It is at this point 
that we begin to be made the victims of disease. Nature has 
great force to resist but she is not all powerful. She cannot always 
resist disease. She can cast off some contagious germs and resist a 



THE NEW MEDICAL AVORLD. 171 

certain amount of poison but when each breath is loaded with poi- 
sonous germs they may get the mastery and effect an entrance into 
the blood where they multiply like yeast in the moistened flour and 
so fermentation ensues accompanied by fever and prostration. If 
nature becomes weakened in any way so that she is unable to elimi- 
nate the poison products of the system the avenues of the body soon 
become clogged and disorder follows. Biliousness, uraemia and other 
troubles manifest themselves. 

Should nature become unable to secure sufficient nutrition to make 
healthy blood anaemia, atrophy, fatty degeneration and many other 
diseases might result. 

When nature is unable to obtain sufficient oxygen to purify the 
blood impurities accumulate and there follows disturbed bodily func- 
tions and disease. In these cases it is not so much medicine that is 
required as improved sanitary conditions which will contribute to the 
restoration of health. 

It is necessary to learn something about the complex working of 
nature in order to help rather than hinder her in her difficult work. 
Medicines cannot do the work of nature for they can at their best 
only assist her as oil does the machine to run more smoothly. 

It may be seen from the article which follows that nature in addi- 
tion to warding off injury has marvelous power to repair injuries 
when they have occurred and can readily accomplish a task so appar- 
ently difficult as the union of fractured bones. 

XIII.— THE FRACTURE OF BONES. 

Fractures are broken bones, often the result of a fall or other 
accident. They are known as simple, compound and comminuted. 

A simple fracture is not complicated by any external wound. A 
compound fracture is where the skin and soft tissues are broken 
through by the ends of the severed bone. When the bone is broken 
into several separate pieces or small fragments the injury is known 
as a comminuted fracture. Other distinctions are also recognized by 
surgeons. A fracture is complete when the bone is broken clear 
across or severed in twain ; it is incomplete when cracked or partially 
broken. Incomplete fractures are common in children, because the 
bones are more elastic, and, like a green stick, they bend rather 
than break. The term green stick fracture is sometimes applied to 
the incomplete fractures of children. A fracture is transverse when the 



172 



THE NEW MEDICAL WORLD. 



bone is broken at right angles or straight across. When the fracture 

is slanting it is known as an oblique frac- 
ture. Fractures occur at all ages. In in- 
fancy the bones are flexible, and usually 
bend rather than break. The bones of 
adults are more brittle, and a complete 
fracture is more likely to result. The 
bones of old people are often quite brit- 
tle, and break from slight falls and in- 




juries. Sometimes muscular action is suf- 
ficient to produce a fracture. In cer- 
tain diseased conditions, as rickets, in 
some forms of atrophy, and when the 
bones are very much weakened by tu- 
mors or syphilis, fractures result from 
slight causes. A fracture may be com- 
A transverse fracture of the plicated by injury of the joint, and then 

humerus, or arm bone. This always awakens unusual concern on ac- 
also shows the tendency to dis- » _,, ,. i.-,*, ^-m 

placement due to the action of count of the liability to a stiff or ail- 

the muscles. chylosed joint. 



SYMPTOMS OF FRACTURE. 



The symptoms of most fractures are characteristic and easily rec- 
ognized as excessive mobility, deformity and crepitus. The charac- 
ter of the fracture determines the symptoms which will be mani- 
fested. If the fracture is transverse there may be no deformity at 
all ; if it is oblique there will be deformity owing to the contraction 
of the muscles, which will cause the ends of the fractured bone to 
ride upon one another thus shortening the injured limb. The mus- 
cular attachments of a fractured bone often cause characteristic dis- 
placement, but in order to understand the peculiar action of the vari- 
ous muscles an extensive knowledge of anatomical surgery is essential. 

After a fall or direct violence resulting in fracture, there is usually 
inability to move the injured limb, but by taking hold of it, it moves in 
an unusual manner as if supplied with an extra joint. This increased 
mobility is artificial and can be readily recognized. The movement 
however causes great pain, and the ends of the bone grate together; 
this grating sound is a valuable and certain sign of fracture and is 
known as crepitus. 



THE NEW MEDICAL WORLD. 173 

Many fractures may be recognized by a shortening of the injured 
limb. After an injury which results in fracture considerable swelling 
quickly follows. This is caused by injury of the soft parts and the 
pouring out of serum from the tissues and blood from the numerous 
small vessels which are ruptured. Comparing the injured limb with 
the sound one is a valuable means of discovering deformity. It must 
be remembered by the surgeon that in the bones of young persons 
there are natural lines of separation known as the epyphyses and 
violence sometimes causes separation at these points. 

Fractures of the bones of the cranium and pelvis are often ob- 
scure and may occur without being recognized. 

TREATMENT OF FRACTURE. 

Much care is required in the examination of a fracture in order not 
to augment the injury. Repeated examinations are unnecessary and 
likely to do further harm. When the extent of the injury cannot be 
made out the patient should be put under the influence of ether in 
order that the full extent of the injury may be learned. As soon as 
convenient after a fracture the patient should be attended and the 
fracture put up or set. 

The rule for treating fractures is the most simple of all directions 
and the most difficult of all to follow. It is as follows : " Bring the 
fractured ends into perfect apposition and keep them there by splints 
or suitable appliances." While the treatment is so simple in theory 
in practice great skill and ingenuity is often required to achieve suc- 
cess. It requires good judgment and considerable experience. 

Wlien a person is injured and a bone broken place the limb in a 
natural position and bind it to a piece of board or stick to prevent 
movement. In, fracture of the lower extremities the injured limb 
may be bound to the sound one after which the patient may be car- 
ried home or to a hospital. If severe bleeding occurs bind a pad 
over the wound and in addition raise the injured limb above the level 
of the head. A fracture is set in the following manner. An assist- 
ant holds the upper part of the broken limb firmly while extension 
is made in the opposite direction to overcome muscular contraction, 
then by means of a little skillful manipulation with the thumb and 
fingers the broken bones are brought into place or coapted. The 
parts having been put into' the right position must be held there as 
immovably as possible. For this purpose well-padded splints of felt, 



174 THE NEW MEDICAL WORLD. 

sole-leather, wood or metal are made use of. Sandbags sometimes 
take the place of splints in fracture of the thigh or femur. Service- 
able splints are also made of plaster of Paris and a great variety of 
other appliances have been used. 

Plaster of Paris dressings are appropriate after all swelling has 
subsided, but are not recommended for the first dressing of fractures 
except in experienced hands. Extension is a valuable remedy in the 
treatment of fractures, especially of the lower extremities. It is 
accomplished in different ways, but most commonly by attaching a 
weight of eight or ten pounds to the foot and leg so as to draw over 
a pulley at the foot of the bed. Counter extension may be accom- 
plished easily by elevating the foot of the bed about six inches. 

Extension counteracts the contraction of the muscles and prevents 
the broken ends of bone from grinding against each other and from 
riding upon each other, as they will when one end slips by the other. 
Without extension there is great danger from shortening and perma- 
nent deformity of the limb. Extension also prevents a large amount 
of suffering from pain. Simple dressings for fractured bones are the 
best, for extemporized splints and other contrivances invented by the 
ingenious surgeon often produce better results than costly appliances. 
Having fixed a fractured limb by extension, sand bags may be placed 
on both sides of the limb to prevent movement, or they may be 
bound to the limb by means of plasters. From such simple appli- 
ances the author has seen almost perfect results, as well as great 
comfort experienced by the patient. 

When the fracture is compound, that is complicated by an external 
wound, it must be thoroughly cleansed by a carbolic or corrosive 1 
sublimate solution, Over the wound some carbolized or iodoform 
gauze should be placed. Under the modern method of antiseptic 
dressing, compound fractures are almost wholly bereft of risk, where- 
as formerly they were regarded with much concern by the surgeon. 

Crushed or smashed Limbs may require amputation when the integ- 
rity of the nerves and arteries are so injured that life in the injured 
parts cannot be maintained, but at the present day many limbs are 
saved and perfectly restored which in former times would have been 
cut off. As nature possesses great recuperative force, it is often 
worth while to wait for her to demonstrate whether or not amputa- 
tion is necessary. 

Broken bones repair rapidly in young persons, only about four 
weeks being required to complete the whole process, but ten weeks 



THE NEW MEDICAL WORLD. 



175 



may be required for the same process in the case of old people. The 
best results are obtained when the broken ends are brought into 
proper position and held there immovably. 

It is impossible to fix a fractured rib or a broken collar bone so as 
to prevent some movement, but this does not prevent a satisfactory 
result. When a bone has been fractured there seems to be but little 
activity toward recovery for a few days ; from the twelfth day 
onward, however, recovery progresses quite rapidly, and in a few 
weeks is complete. When the splints are removed from a fractured 
limb there is usually considerable stiffness, but rubbing the muscles 
with oil, and constant use, soon brings about perfect recovery. 

It sometimes happens, though rarely, that a fracture fails to unite, 
owing to debility, or to a separation of the bones, by the interven- 
tion of some of the soft tissues. In such cases the surgeon's skill is 
usually adequate to remedy the difficulty. Time and patience are 
essential in all instances to the perfect repair of fractured bones. 

Of the special fractures only a few of the more common w ill be 
noticed. In fractures of the collar bone, or clavicle, the arm should 

be lifted upward, outward and back- 
ward by the application of a suitable 
bandage. Rest upon the back, in 
bed, accomplishes this purpose ad- 
mirably and should be encouraged. 
Fractures of the radius, or wrist, are 
common from falls. This fracture 
is usually dressed with two padded 
/ s\ -" m "'V^' — d>W !$$;■ |k /Jy / 1 §§1 splints, and the forearm is suspended 

so that the hand rests against the 
chest with the thumb looking up- 
ward toward the face. The splints 
need to be worn three weeks, and 
often longer. Fractures of the hip, 
or femur, are all best treated by 
means of extension to overcome the 
contractions of the powerful muscles 
m these regions, and sandbags may 
be used to lessen the need of 
An oblique fracture of the collar bone, splints. Fractures which involve the 

The shoulder drops, and there is much • • , i i -i i .en j. i i 

displacement of the ends of the broken 3 011lts sll0uld be carefully watched, 
bones. and passive motion employed at the 




176 THE NEW MEDICAL WORLD. 

right time to insure success and prevent an unfortunate stiffness of 
the injured joint. For fracture of the spine see injuries of the spine. 
The repair of fractured bones, if possible should be under the direc- 
tion of the surgeon. 

XIV.— DISLOCATIONS. 

Dislocation occurs at some joint and is commonly the result of vio- 
lence, the head of the bone being wholly or partially forced out of 
the socket or articulation. In many instances the surrounding liga- 
ments of a joint are torn and injured as well as the muscles and other 
soft parts. When a dislocation has occurred the sooner the bone is 
put back into place the better. On account of swelling, it is some- 
times difficult to determine whether a bone has been dislocated or 
not as the result of an injury, but typical cases are readily rocognized. 
Dislocations are sometimes overlooked or mistaken for sprains. 

SYMPTOMS. 

The prominent symptoms of dislocation are deformity, loss of vol- 
untary motion and limited mobility. There is an absence of crepitus. 
In cases of doubt it is the best plan to put the patient under ether 
when the injury can be readily made out and reduction at once ac- 
complished. When a fracture complicates a dislocation there may 
be considerable trouble experienced in making out the extent of the 
injury. 

TREATMENT. 

This should be prompt and efficient. The dislocations of the small 
joints can be reduced readily by making extension and suitable manip- 
ulation ; the head of the bone slips into place and natural mobility is 
restored. In reduction of the hip and other large joints, ether should 
be used in preference to the employment of any considerable force. 
The patient when brought under ether is in a state of muscular relax- 
ation and manipulation can be accomplished without pain and the 
reduction of the dislocation is easily accomplished. 

The head of the bone goes back through the rent made in the cap- 
sular ligament at the time of injury, if the manipulation is skillful. 
The after treatment consists in rest and hot packs to reduce the 
swelling and allay inflammation. Three or four weeks may be re- 



THE NEW MEDICAL WOULD. 



1 



i i 



quired for the recovery of a dislocated joint, although passive move- 
ment can be permitted after a couple of weeks and in some cases 
sooner. Dislocations can be reduced, weeks after they occur, by the 
aid of ether, but old adhesions have to be broken up by force and 
the risk is greater than in recent injuries. 

SPECIAL DISLOCATIONS. 

A few of the more common dislocations will be mentioned in de- 
tail but it would be impossible to give directions so that the un- 
skilled could reduce the various dislocations which are liable to 
occur. 

Dislocation of the shoulder is common and there are several vari- 
eties of this injury. It can usually be reduced by skillful manipula- 
tion without the use of ether. Dislocation at the elbow is less com- 
mon, the radius and ulna being pushed backward. This gives the 
elbow a peculiar appearance which having been seen once will be 
readily recognized. This injury is easily reduced with the patient 
under ether by making extension upon the forearm bent at the elbow 
at right angles. 

A dislocation of the hip is a grave accident as considerable force 
is usually required to produce it. There are several varieties of this 
dislocation. It will require a competent surgeon to treat an injury 
so serious as dislocation of the hip, and indeed for all the important 
dislocations the same is true, for no description or plates could give 
the ability sufficient to do this important branch of surgery. It re- 




Dislocation of the third bone of the index finger, showing how to reduce it. 

quires that skill which alone results from study, observation and ex- 
perience. Dislocation of a finger, thumb or even the wrist anyone 
could probably reduce by grasping the forearm with one hand and 
pulling in a straight direction upon the dislocated member with suffi- 
cient force to bring it into place. 



178 THE NEW MEDICAL WORLD. 

Dislocation of the lower jaw sometimes takes place from gaping or 
opening the mouth too widely. This injury can be reduced by plac- 
ing the thumb of each hand upon the lower back teeth and making 
pressure downward and backward; the thumbs should be wrapped 
with a piece of muslin for protection. A very small amount of skill 
is sufficient to overcome this dislocation. Dislocation of the vertebrae 
of the spine is treated of under injuries of the spine. A dislocated 
knee cap could be brought back into place by straightening out the 
leg and pushing the patella into place with the thumb and fingers. 



CHAPTER IX. 
THE BLOOD AND ITS DISEASES 



I. — Anjemia. II. — Chlorosis. III. — Leukaemia. IV. — Septi- 
cemia, Pyjemia, Blood Poisoning. 

THE BLOOD. 

THE blood is a crimson fluid which holds in solution a large 
number of solids. It circulates through the arteries, capillaries 
and veins, and changes its color from a rich scarlet to a dark red, 
owing to changes which take place during the circulation. The 
blood is a complex substance. It contains a colorless nutritive fluid, 
blood corpuscles, fibrin, albumen, chlorides of soda and potash, phos- 
phates of soda, lime and magnesia. These mineral substances are 
held in solution and give it a saltish taste. 

The blood also contains iron in solution, which gives to it color, 
and also colors many of the tissues which it nourishes. The blood 
contains a vast number of disks, called corpuscles. These are of two 
kinds, red and white. The red are smaller than the white, being 
3 £ of an inch in diameter, and they are also much more numerous. 

In some diseases these corpuscles are very greatly changed, and an 
examination of them shows their number much increased or dimin- 
ished and the ratio between the white and red to be much disturbed. 
Other changes may occur, so that an examination of the blood is 
often of much importance and aids in ascertaining the proper line of 
treatment for some obscure diseases. 

The red corpuscles in the blood of man differ somewhat from those 
of other animals. This is of considerable importance in the conviction 
of criminals and the vindication of the innocent. 

An explanation of the appliances for examining the blood and de- 
termining the number of corpuscles would be of so little interest to 
the general reader, that the few interested in such studies are referred 
to scientific works upon this subject. 

The reaction of blood is alkaline. This is determined by litmus 
paper, an acid fluid turning blue litmus red, while an alkaline fluid 
turns red litmus blue. 



180 THE NEW MEDICAL WORLD. 

The specific gravity of the blood varies between 1045 and 1075. 
If you weigh a thousand grains of water the same measure of blood 
would weigh from forty-live to seventy-five grains more. The quan- 
tity of blood is about one-thirteenth of the weight of the entire body. 

Blood after being drawn from the veins and standing awhile sepa- 
rates. That part which contains the fibrin solidifies, the fibrin enclos- 
ing in its meshes the corpuscles. This part is called the coagulum or 
clot, while the thin fluid which remains is the serum. 

The circulation of the blood is carried on chiefly by the heart 
which throws or pumps a new quantity out into the arteries at every 
beat. The arteries diminish in size as they recede from the heart 
and give off many branches on the way, spreading out like a branch- 
ing tree. 

The capillaries are a fine network of vessels, a continuation of the 
arteries, and it is while the blood is passing through them that the 
different organs and parts take from the blood fluid, that nutrition 
which is required for their maintenance and for the performance of 
their functions, and return to it the waste products which must either 
be wrought over into new material or eliminated from the system. 

The blood in the arteries is bright red for the reason that before it 
is pumped out of the left ventricle of the heart, it has just returned 
from the lungs where it has lost its carbonic acid and received a fresh 
and bounteous supply of oxygen. The difference between arterial 
and venous blood is chiefly this, that venous blood is deprived of 
oxygen and loaded with carbonic acid while arterial blood is deprived 
of carbonic acid and loaded with oxygen. 

The blood corpuscles have great affinity for oxygen and are able 
to take it from the air through the thin, moist membrane in the lungs 
which separates the blood from the air ; the carbonic acid also passes 
out through this thin membrane and vitiates the respired air. 

The circulation of the blood is fully explained elsewhere. (See 
chapter on the heart.) 

Disease's of the blood are frequent but most of these are somewhat 
obscure. The most common and important disease of the blood is 
anaemia. 

I.— AN/EMIA. 

The name of this disease is derived from the Greek language, and 
signifies bloodless. This, however, fails to convey the precise mean- 
ing of the term. It is a disease due to an impoverished or reduced 



THE NEW MEDICAL WORLD. 181 

state of the blood. This fluid becomes thin and watery and does not 
contain sufficient nutritive elements for sustaining and building up the 
weakened body. 

There is found to be a great reduction, sometimes amounting to 
one half, in the number of the red blood corpuscles, which are essen- 
tial to health. The cause of this condition may be a direct loss of 
blood, as in frequent or profuse hemorrhages. By overtaxing the 
nervous system with anxiety, care or loss of sleep, as occurs in 
taking care of the sick, nutrition is impaired and a condition of 
anaemia is developed. 

Living in poorly ventilated or over heated rooms, neglecting out- 
door exercise, excess of study, which draws away the blood supply to 
sustain the activities of the brain ; novel reading, which consumes the 
mental force by .trifling with the emotions ; unnatural excitements, 
which use up the nerve force ; irregular, unwholesome or insufficient 
food, or a diet consisting chiefly of pastry, confections and nick- 
nacks ; in fact, any mode of life which prevents full compensation for 
the bodily wastes sooner or later brings on an anaemic condition. 

Young women in boarding, schools, as a class, are especially liable 
to suffer from this trouble, on account of monotonous fare, over 
study, want of exercise or loss of appetite. It is impossible to pro- 
long mental labor and escape anaemia without sufficient, wholesome, 
nourishing food and good digestion. 

There are not a few diseases, as fevers, rheumatism, consumption 
and dyspepsia, which diminish the nutritive elements contained in 
the blood and reduce it to a thin and watery condition. 

The physician recognizes this disease at a glance, often in passing 
a person on the street, its symptoms are so well marked and char- 
acteristic; whereas the patient's friends are slow to interpret the cause 
of the pallid countenance. Its approach is so insidious that months 
are wont to pass before the patient's friends are aware of the situ- 
ation, hence it will be well to give heed to the following symptoms, 
which are easily recognized. 

SYMPTOMS. 

The cheeks, lips, and even the tongue, look pale, the ears are quite 
transparent, the veins have a dark, empty appearance, the heart beat 
is weak and rapid. These symptoms are intensified by emotion or 
exercise, and physical and mental fatigue follow slight exertion. 
Climbing a hill or ascending a flight of stairs produces rapid breath- 



182 THE NEW MEDICAL WORLD. 

ing, quickened action of the heart and perhaps palpitation. The 
emotions are easily excited, and such persons are often subject to faint- 
ing attacks or symptoms of hysteria, such as laughing or crying with- 
out cause. The feet and hands suffer from cold on little exposure 
and the whole bodily condition is one of debility. 

TREATMENT. 

This requires the use of varied means. Exercise in the open air 
and sunlight are valuable aids to recovery. Judicious bathing with 
friction of the skin, a nutritious diet, rest, change of scene and rec- 
reation are helpful and sometimes these simple remedies alone will 
be sufficient to improve the condition. 

Bitter tonics are often indicated to improve the appetite and pep- 
sin to assist digestion. In the most persistent cases of anaemia iron 
in suitable amount is an agent of great efficiency. Nux vomica is 
also a valuable remedy to aid the blood-making functions. The fol- 
lowing prescription has been thoroughly tried and will benefit a large 
majority of cases. 

^ Podophyllin one grain 

Reduced iron twenty grains 

Ext. nux vomica four grains 

Ext. gentian twenty grains 

Piperine five grains 

Mix and make twenty pills. Dose, one three times a day after 
meals. 

If the condition of anaemia is the result of malaria from twenty to 
forty grains of quinine may be added to the above prescription. 
When indigestion exists three grains of concentrated pepsin may 
be taken with each meal. The above doses are intended for adults. 

It may be added that chronic constipation is often associated with 
the worst forms of anaemia and should be remedied before decided 
improvement can be expected. For its treatment see constipation. 

II.— CHLOROSIS. 

Chlorosis is an affection of girls at the age of puberty and is some- 
times called green sickness. It is closely related to anaemia if not, a 
held by some authors, identical with it. The blood is in an impov- 



THE NEW MEDICAL WORLD. 183 

erished condition and there is a deficiency in the number of red 
blood corpuscles. There is usually lack of nourishment owing to 
poor appetite or deficient food supply. 

SYMPTOMS. 

The symptoms are headache, palpitation, shortness of breath, a 
feeling of fatigue and an inclination to sleep. Other symptoms are 
loss of appetite, inability to labor either with the hands or mind, cold 
feet and hands and pallor of the skin. 

TREATMENT. 

The treatment demands plenty of nourishing food, exposure to the 
fresh air and sunlight, sea air and sea bathing, light gymnastics and 
the use of the remedies suggested for anaemia to stimulate the blood- 
making functions. 

III.— LEUKAEMIA. 

This is a name given to a disease characterized by a large increase 
in the white blood corpuscles and a diminution in the red. 

The spleen and lymphatic glands are usually enlarged and the 
color of the blood is more or less diminished. 

The symptoms are marked pallor, enlarged spleen and enlargement 
of the glands in the neck and armpit. Hemorrhage from the nose 
occurs frequently and is difficult to control. 

Unless relief is obtained these symptoms are intensified, the pallor 
becomes more marked, hemorrhages are more frequent, fever or 
dropsy may develop, and a fatal debility at length supervenes 

Malaria seems to be in some cases the forerunner of this affection- 
The treatment demands improvement of the nutrition and strength. 
The remedies recommended for anaemia are appropriate also for this 
affection. 

IV.— SEPTICEMIA— PYAEMIA. BLOOD POISONING. 

The term blood poisoning has come into such prominence, during 
the last decade, that a few words upon this important subject will 
not be out of place in a work upon household medicine. 

Blood poisoning refers to a condition of the bldod and not to a 



1*4 THE NEW MEDICAL WORLD. 

particular disease. It is the result of some septic or purulent mate- 
rial, the product of inflammation, circulating in the blood. Nature 
attempts to eliminate these purulent products by absorbing them 
into the general circulation and then carrying them in the blood cur- 
rent to the different organs to be cast out of the body. 

When there is acute inflammation in any part or organ of the 
body, as the result of disease or injury, more or less poison material 
is absorbed into the system. When these toxic, or putrid, products 
are not too numerous they are eliminated from the body with ease, 
along with the natural wastes of the system, which, if retained, would 
soon act as violent poisons. When, however, these purulent prod- 
ucts are so abundant as to overwhelm and paralyze the nervous 
system, so that they cannot be removed, the patient at length 
becomes stupid or comatose and the whole machinery of the body 
stops. -It is in this way that death results from blood poisoning. 
Sometimes abscesses break out upon the limbs, nature making an 
effort in this manner to assist in the work of elimination, but when 
abscesses form in the lungs or other internal organs death invariably 
results. 

Septicaemia and pyaemia are the names of the condition described, 
but known to the people as blood poisoning. 

Septicaemia is the term applied to the milder forms of blood poi- 
soning. Pyaemia is the term applied to those severe conditions in 
which abscesses are formed in the internal organs or joints ending 
usually in death. The primary cause of septicaemia is often some 
injury which is regarded as slight till the symptoms of blood poison- 
ing manifest themselves. 

It is Avell remembered that President Garfield died of pyaemia or 
blood poisoning. In his case the injured bone was doubtless the 
cause of the trouble. Nature attempted to remove the dead particles 
of bone. This purulent material was absorbed into the general cir- 
culation but nature was unable to complete the work she had under- 
taken ; for she could not eliminate the poison and abscesses formed 
in the lungs, and the whole system at last infected and poisoned 
yielded to the inevitable. 

Blood poison follows surgical operations but much less often than 
formerly, owing to anti-septic dressings. Injuries of the bone are 
more liable to be followed by these disasters than other injuries. 

Severe or malignant blood poisoning is liable to follow diphtheria, 
scarlet fever, malignant pustule, glanders, childbirth ami in mild 



THE NEW MEDICAL WORLD. 185 

form all the germ diseases as erysipelas and consumption. In fact 
nearly all disease is due to waste or toxic material circulating in the 
system. 

SYMPTOMS. 

The symptoms of blood poisoning are severe chills, fever, striking 
variations of temperature, profuse sweating and great depression of 
the powers of life. Should the symptoms be severe, it indicates that 
the attack is also severe. The symptoms usually come on in about 
nine days after an injury. The wound becomes fetid, its discharge 
is thin and unhealthy. After a severe injury or after capital opera- 
tions symptoms of blood poisoning are usually absent, but they may 
supervene after very slight injuries. There is this element of uncer- 
tainty,, but in recent years the risk has greatly diminished. Every 
degree of severity may be manifest in the sjnxiptoms of blood poison- 
ing. They may be so slight as to last only a few hours, or so severe 
and prolonged as eventually to produce death. 

TREATMENT. 

After injuries and surgical operations every effort should be made 
to prevent blood poisoning, by looking after every detail, as clean- 
ness of the wound, fresh air, nutrition and diet. Sewer gas must not 
be permitted to enter the patient's apartment. If pus forms arrange- 
ments must be made for its escape, and the wound washed thoroughly 
with an ti- septic solutions, as carbolic acid or corrosive sublimate. 
The proper strength of these solutions is given elsewhere in detail. 
Cleanliness should be emphasized as the most important of all 
measures. Sponges are objectionable and should not be used unless 
thoroughly disinfected and scrupulously clean. 

A charcoal poultice will often improve the character of a septic 
wound. For a high grade of surgical fever give quinine in generous 
doses combined with phenacetine as follows. 

fy Quinia sulphate one dram 

Phenacetine thirty grains 

Mix and make in twelve capsules. One of these may be given 
every four hours if the fever is severe until the temperature is re- 
duced. 



186 THE NEW MEDICAL WORLD. 

The diet should be nutritious. Milk, eggs and animal broths 
should be used. Stimulants may be required but must always be 
used with caution. Morphine may be used for pain and chloral or 
sulphonal to produce rest but always cautiously. 

It would be better to confine the term blood poisoning to those sep- 
tic conditions which follow operations or injuries and where some 
septic material is inoculated into the system as in malignant pus- 
tule, glanders and diseases of similar type. The poison of other 
diseases as typhoid fever, small pox, scarlet fever, diphtheria, gon- 
orrhea and syphilis should be recognized and treated under their 
own individual names, and not under the name of blood poisoning. 



CHAPTER X. 

THE LYMPHATIC SYSTEM AND GLANDU 

LAR DISEASES. 



I. — The Lymphatic System. II. — Scrofula. III. — The Pan- 
creas. IV. — Diseases of the Pancreas. 

I._THE LYMPHATIC SYSTEM. 

WITHIN the body and found in most of the tissues is a system 
of delicate vessels which form a minute network converging 
toward the interior. They are more numerous but of smaller size 
than the blood vessels. They communicate with glands which are 
also numerous in certain locations as the neck, the axilla, the bend 
of the elbow, the groin, under the knee, in the mesentery and in 
many other situations. These vessels absorb liquid material from the 
tissues and convey it into the general circulation. The lymphatic 
vessels are also known as absorbents and lacteals. 

The lacteals are more properly the lymphatic vessels of the small 
intestines, so named because during the process of digestion they 
contain a milk- colored fluid sometimes known as chyle. Chyle dif- 
fers from lymph in that it contains a large amount of flat globules in 
a finely divided or emulsified state. The chyle is absorbed by the 
villi of the small intestines and is rich in nutritious material. It is 
mixed with the lymph and enters the circulation through the same 
channel. 

The great central canal which conveys the lymph and chyle into 
the blood is called the thoracic duct. It is eighteen or twenty 
inches long and about the size of an ordinary goose quill. To this 
common duct the lymphatic vessels converge, bearing the products 
they have absorbed in their course, just as little streams drain the 
country of a certain region and convey it to the river, which swallows 
up all its tributaries. The thoracic duct passes up the body in front 



188 



THE NEW MEDICAL WORLD. 



of the spinal column, carrying this liquid current which is emptied 
into the left subclavian vein, quite near the heart and it is then mixed 
with the venous blood. 

These lymphatic vessels contain valves to prevent the fluid from 
flowing in the wrong direction and the opening of the thoracic duct 




Lymphatic vessels and glands of the head, face and neck. 

is also guarded by valves to prevent the venous blood from entering 
it. The lymphatic vessels are numerous in the cellular tissues be- 
neath the skin and it is owing to this fact that medicines injected 
beneath the skin are absorbed so quickly and produce characteristic 
results with such certain ty. 



THE NEW MEDICAL WOULD. 189 

II.— SCROFULA, KING'S EVIL. 

Scrofula has reference to a peculiar condition or diathesis of the 
system, in which there is a tendency to develop certain disorders of 
the glands, joints, bones, skin, and various other tissues and organs. 
It is concerned in indolent growths of the glandular system, and in 
slowly progressing inflammations, which are liable to end in the 
formation and discharge of pus, from a sore showing great unwilling- 
ness to heal. It often pursues a tedious and intractable course. It 
is largely a disease of childhood, and rarely develops after twenty 
years of age. 

CAUSES. 

Among the predisposing causes, heredity has always been believed 
to occupy a strong place. It has been regarded by many as the 
result of syphilis, manifested in succeeding generations, or several 
removes from the original source. Others believe it to result 
from some faulty composition of the blood, whereby it contains mor- 
bific or disease producing elements. All agree that it is a disease of 
faulty nutrition, and whatever disarranges these functions is favorable 
to its development. 

Improper sanitary conditions are found to have a strong place in 
the development of scrofula, as polluted atmosphere, cold and damp 
situations, improper foods, unhealthy localities and habits of life. 

It has been observed that scrofula is often brought into activity by 
the injurious effects of certain diseases, as typhoid, and scarlet fever, 
or measles. Diseases of the eyes, ears, various catarrhs and eczema 
are often properly regarded as forms of the manifestation of scrofula. 

Scrofulous swellings of the glands in the neck, or chronic dis- 
charges from the ear, may follow attacks of mumps, diphtheria, measles 
and scarlet fever. Falls or injuries may appear to be. the starting 
point of cases of this affection, and so slight an operation as vaccina- 
tion might cause scrofula to develop if already in the system, but in 
the author's experience this has never occurred, and in the experience 
of others but rarely. It has been known to result from the severe 
drain upon the system due to frequent pregnancies and lactation, but 
this also is rare. 

Many have thought tubercular disease and scrofula closely related, 
or perhaps the same, but the' ground for such belief disappeared with 
the discovery of the bacillus of tubercle. It is possible, however, 



190 THE NEW MEDICAL WORLD. 

that those who have manifested the condition of scrofula in early 
life are more liable to become the victims of tubercular consumption 
at a later period. 

SYMPTOMS. 

The symptoms of scrofula may develop in any temperament or con- 
dition of early life, owing to the activity of the lymphatic glands at 
this period. Children who develop scrofula are apt to be pale, have 
soft, flabby muscles, and a capricious appetite, but to this statement 
there are frequent exceptions. 

Children who are fussy about their food at the table, rejecting 
hearty articles of diet, and removing every shred of fat from a piece 
of roast, choosing starchy foods and sweet substances are especially 
prone to scrofula. Such children always feel the cold, and hover 
about the register ; their teeth show signs of early decay. With 
them injuries produce unexpected results, abrasions are slow to heal, 
and their wounds are hard to cure, while pus shows a tendency to 
form on slight provocation. 

Joint troubles, glandular swellings, abscesses slow to form and 
loth to heal, a discharge from the ear and a tendency for such ail- 
ments to become chronic, these and similar symptoms, indicate that 
condition to which the term scrofula has been given. 

TREATMENT. 

Preventive measures must consider the marriage of persons who 
are unlike in physical temperament, or, in other words, who are 
physically compatible. Two persons who have had the scrofulous 
tendency in early life should not marry each other. Families afflic- 
ted with the scrofula diathesis, and related, should not for a moment 
consider the thought of intermarriage, for the result would be puny, 
scrofulous children, liable to die at an early age. 

Children should not sleep in the same bed with their parents. 
Children and young persons must not sleep in bed with old people. 
This is a law that ought not to be violated. 

Pure air and constant attention to the subject of ventilation will 
do something to prevent the development of this struma. 

School-rooms should be looked after to prevent over crowding, 
and to see that pure air, pure water, and thorough ventilation are 
supplied. Good appetite, good digestion, nutritious food and syste- 



THE NEW MEDICAL AVORLD. 191 

matic bathing are all in the line of the best preventive remedies. 

Artificially fed babies need close attention, for they are especially 
liable to develop scrofulous affections. 

As regards medical treatment, the syrup of the iodide of iron is a 
valuable remedy. It may be given in doses of from ten to thirty 
drops to children under five years of age, and to older persons one 
teaspoonful three or four times a day. The teeth must be protected 
from its injurious effects. Cod liver oil is beneficial in thin, scrawny 
children, who are destitute of fat tissue. 

The following is a good prescription : 

fy Lacto- phosphate of lime four ounces 

Pulverized acacia two drams 

Oil of bitter almond six drops 

Cod liver oil four ounces 

Mix. The dose is from one teaspoonful to a tablespoonful, accord- 
ing to the age. 

III.— THE PANCREAS. 

The pancreas is a glandular structure situated behind the stomach. 
It extends from the spleen on the left to the duodenum on the right, 
a distance of six or eight inches. Its shape is compared to a dog's 
tongue, the pointed end of which touches the spleen. It is an inch 
or more in thickness and an inch and a half in width and weighs two 
or three ounces. 

The right end is broader and curved downwards fitting into a 
curve in the duodenum. It contains a duct about the size of a goose 
quill which empties into the duodenum. In structure the pancreas re- 
sembles the salivary glands. It secretes a fluid which is conveyed 
by the duct already mentioned into the duodenum or small intestine. 
This secretion mingles with the substances that have been acted upon 
by the gastric juice in the stomach. Its principal ingredient is called 
pancreatin and except for this the secretion almost completely re- 
sembles saliva. The pancreatin forms about ten per cent, of the 
whole secretion and renders the fluid thick and viscid. 

The secretion of the pancreas is alkaline in reaction and unites 
with fats and oils to form an emulsion. It together with the secre- 
tion of the liver is the great -factor in the digestion of fats and oils. 
It also converts starch into glucose or sugar at the bodily temperature 



Hi'2 



THE NEW MEDICAL WORLD. 



with great rapidity. Fatty substances are not acted upon in the 
stomach but their digestion follows the passage of food into the 
small intestines. The action of the secretion of the pancreas is of 
great importance in the digestion of food which always contains a 
greater or less amount of fatty material. 

The emulsified food is known as chyle. 

The pancreas is active during the process of digestion and pours 
out a large amount of fluid and after the process is over it returns to 
a state of quiescence. 

It should then be remembered that fatty substances are digested in 
the small intestines and that the chief agent in this process is the 




The Panckeas and Spleen. 

pancreatic juice which emulsifies them. Emulsified fats form a thick 
white fluid, chyle, which in appearance resembles milk. This proc- 
ess will be referred to later when the functions of the intestines are 
considered. 

IY.—DISEASES OF THE PANCREAS. 

Diseases of the pancreas are neither numerous nor common. In- 
flammation of the pancreas may take place but it is rarely recognized 

as the symptoms are few and similar to bilious colic and neuralgia of 
the stomach. 



THE NEW MEDICAL WORLD. 193 

The only common affection of the pancreas about which much is 
known is cancer. The earliest symptom is persistent pain in the epi- 
gastric region and at length fat globules appear abundantly in the 
stools, jaundice and dropsy usually appear but those symptoms are 
confusing. Digestion is also disturbed. Other symptoms may arise 
from pressure by the growth upon neighboring vessels and organs. 

There is the same peculiar waxy look as seen in those suffering 
from cancer of the stomach. The same internal treatment is appli- 
cable as in cancer of the stomach or other internal organs. 

The progress of the disease is onward, and terminates fatally in 
one or two years. This gland may undergo fatty degeneration, but 
as diseases of the pancreas are more or less obscure till after death, 
an extended discussion would be out of place in a hand book of 
domestic practice. 



CHAPTER XL 

THE SKIN — ITS ANATOMY, FUNCTIONS, 

AND DISEASES! 



I. — The Skin. II — Management of the Skin. Ill — Cosmetics. 
IV. — General Observations on Diseases of the Skin. 
V. — Disorders of the Sweat Glands. VI. — Disorders 
of the Sebaceous Glands : «, Seborrhea or Dandruff; 
b, Wens or Tumors of the Scalp; c, Baldness or Alo- 
pecia. VII. — Acne and Comedo. VIII. — Milium. IX. — 
Prurigo, Itching or Pruritus. X. — Shingles or Herpes 
Zoster. XI. — Eczema, Tetter, Milk Crust or Salt 
Rheum. XII. — Urticaria, Hives or Nettle Rash. XIII. 
— Psoriasis. XIV. — Leprosy. XV. — Lice or Pediculo- 
sis. XVI. — Itch or Scabies. XVII. — Ring Worm or 
Tinea. XVIII. — Favus. XIX. — Freckles or Lentigo. 
XX. — Moles. XXL — Warts. XXII. — Corns or Clavus. 
XXIII. — Bunions. XXIV. — Scurvy. 



i 



I.— THE SKIN. 

N order to explain the functions of the skin it is necessary to give 
a general description of its anatomy. It will be sufficient to say 
that the skin is made up of two layers although others are sometimes 
given. The derma or true skin and the epidermis or scarf skin, also 
called the cuticle. 

The epidermis or scarfskin is a tough layer upon the outside of 
the body varying in thickness in different places, conspicuously upon 
the hands and soles of the feet. It is composed of flattened cells 
which are constantly exfoliated and renewed by the growth of the 
parts underneath. It forms a covering for the true skin, it limits the 
evaporation of fluids from the body, prevents the absorption of poi- 
sons and protects from other injury. 

The epidermis is rendered thick by the sunlight and rough usage 
but is soft, thin and smooth where the body is protected by clothing 



THE NEW MEDICAL WORLD. 195 

or otherwise from exposure. While the outside is dry and tough and 
constantly becoming waste to be cast off, the inner surface is soft, 
moist and more like living tissue. 

The scarfskin contains a substance called keratin which neither 
water nor alcohol will dissolve. The microscope is essential to aid 
in studying and understanding the anatomy of the skin. The color 
of the skin is due to a pigment deposited in the lower layer of the 
epidermis. The amount of pigment is influenced by the rays of the 
sun. In hot or tropical countries people have yellow, brown or black 
skins. 

The dermis or true skin lies beneath and in contact with the epi- 
dermis. It is composed of strong, dense, tough fibers which inter- 
lace each other, some of which possess elastic properties. It 
also contains nerves and lymph vessels while the whole is traversed 
by a network of small blood vessels which make it appear red 
wherever the scarfskin is removed. It varies in thickness in differ- 
ent places. The skin rests upon a layer of connective tissue and 
fat. 

The skin has a variety of appendages as hair, nails, sudoriferous 
and sebaceous glands. 

The roots of the hair or hair bulbs are deeply implanted in the 
derma or true skin and in close contact with a little papillary eleva- 
tion which contains a blood vessel that supplies nutrition. Each 
hair is composed of a shaft outside a central pith. 

The nails are similar in composition to the epidermis of which they 
are a modification. They are firmly attached to the skin and seem 
to be chiefly designed to protect the ends of the fingers and toes. 
The main portion is called the body and the lower portion from 
whence growth takes place is called the matrix. 

The sebaceous glands are little bodies imbedded in the lower strata 
of the true skin, where they secrete an oily liquid. They are more 
numerous in the scalp and face than in other parts of the body. 
About the face and nose they are often large and become congested, 
containing a thick, oily secretion, which, when pressed out, resembles 
very much a small worm. 

The sebaceous glands open usually by means of a little duct into 
the hair follicles close beside the hair bulb, and the secretion lubri- 
cates the hair and prevents it from becoming dry and brittle. On 
the face the sebaceous glands 'open mostly upon the surface of the 
skin, and prevent it from becoming parched and chapped by the 






19u 



THE NEW iUiDK'AL WORLD. 



sun's rays. In hot countries these glands dp not secrete sufficient 
material to protect the face and hands, and oil is used to supply the 
deficiency and prevent the exposed parts from chapping. 

The sudoriferous, or sweat glands, are very numerous, and are 
found throughout the entire surface of the body. They present little, 
valve-like openings upon the surface, which are connected by spiral 
tubes, or ducts, with little yellow globular glands, situated on the 
under surface of the true skin. These tubes, or ducts, which lead to 
the surface are presided over by delicate little sensitive nerves, which 




~d 



A Section op Human Skin Magnified. 
a, the epidermis, or scarfskin ; b, the true skin, or dermis ; c, fat colls under the skin ; 
</, a sweat {,'land with a duct, or canal, leadincr to the surface ; «, a hair bulb with a shaft 
Leading to the surface ; ./', sebaceous glands near the hair shaft. 

reBpond to the influence of heat and cold. The latter contracts and 
the former expands these tubes. r rhis is an arrangement for regu- 
lating the temperature of the body. 

These tubes, which convey the moisture to the surface, are large. 
and exist in great numbers in the armpits and groins, and hence in 
these places free prespiration takes place. In the palms oi the hands 



THE NEW MEDICAL WORLD. 197 

the sweat glands are very numerous, but much smaller usually than 
in the armpits, otherwise the moisture of the hands would be quite 
annoying in summer. It is estimated that there are between two and 
three millions of these sudoriferous, or sweat glands, in the human 
body, every one connected with the surface by a spiral canal and 
valve-like orifice, and if all these tubes were stretched into one con- 
nected line it would measure over eight miles. 

The body is always perspiring, but when the amount is unobserv- 
able it is called insensible perspiration. When the body becomes 
over heated by hot weather, by exertion, or artificial heat, these 
tubes dilate and the activity of the sweat glands is greatly increased, 
so that drops of moisture are seen trickling down from the face. 
Men in the hay field, or those working upon the railroad track, and 
elsewhere, often sweat profusely, and are obliged to drink large and 
copious draughts of water to replace that lost by the evaporation 
going on at the surface of the body. 

With this moisture a large amount of waste material is carried out, 
which amounts in an active person to over two pounds daily. Work 
always means destruction of tissue, and the debris must be removed ; 
for it is charged with carbonic acid gas. It will be seen that a process 
quite similar in some respects to respiration goes on in the skin 
by means of the sweat glands. Not only does carbonic acid gas pass 
off through the pores, but a small amount of oxygen is absorbed. 
This process of absorbing and expelling gases is essential to the main- 
tenance of animal heat. Animals that have been varnished over 
soon die and the blood is found to be deficient in oxygen. 

The process of sweating performs two main objects ; the elimina- 
tion of waste and the increase of evaporation whereby the animal 
heat is reduced and prevented from becoming excessive. Hence it is 
that we can be exposed to high ranges of temperature without serious 
injury and that the skin is able to assist the kidneys in eliminating 
waste products from the system. 

The odor of assafcetida, musk, garlic and sulphur can be detected 
in the perspiration soon after being taken in considerable quantity 
into the stomach. It is also probable that every human being ex- 
hales a peculiar odor in his perspiration which enables a dog whose 
sense of smell is very acute to distinguish one person from another 
and several hours after to recognize the track of his master. The 
dog probably recognizes as great difference in the odors of two per- 
sons as we do in their form and features. 



198 THE NEW MEDICAL WORLD. 

The blood vessels of the skin are very minute arteries and capilla- 
ries growing smaller and smaller as they extend upward toward the 
surface. They are very numerous, forming a complete network 
throughout the true skin and so dense are they that the prick of the 
finest cambric needle wounds several of them. The fibers of the 
skin cross each other obliquely thus leaving small openings through 
which the blood vessels and nerves pass and form a terminal net- 
work, which are finalky gathered together in little elevations under 
the epidermis. These elevations can be plainly seen in the palm of 
the hand and inner side of the fingers. When these blood vessels 
have reached their highest point and smallest size they terminate in 
returning veins which pass back through the openings already 
described. 

The blood vessels of the skin supply the glands, the hair follicles 
and all the other tissues connected with it with that abundant nutri- 
tion which is essential for their warmth and development. So small 
are they that they measure less than a thousandth part of an inch in 
diameter, but they are capable of a large amount of expansion should 
the sensitive little nerves which preside over them be temporarily 
paralyzed or suffer shock as is the case in the familiar act of 
blushing. 

After intense cold is experienced and before the nerves have re- 
covered their activity marked congestion of the skin is noticed. Bel- 
ladonna or atropia in full or repeated doses temporarily disables or 
paralyzes the terminal nerves and allows a large amount of blood to 
be thrown into the superficial blood vessels. Sometimes such a 
course is pursued in giving medicine in order to congest the blood 
vessels of the skin and relieve congestion of the lungs and other 
internal organs. The ease with which the superficial blood vcsm-K 
dilate is sometimes a great relief to the delicate and sensitive organs 
within. 

The nerves of the skin are numerous forming a delicate network 
of fibers. The greater part of these are acutely sensitive and supply 
us with the delicate sense of touch. Others preside over the blood 
supply and nutrition and regulate all the various functions of the 
skin, including absorption and secretion of the glands. Various sen- 
sations as of pressure and pain, heat and cold, soft and hard, smooth 
and rough, are transmitted to the brain by means of these terminal 
nerves whose sense of touch is exceedingly delicate. 

These nerves of touch are gathered together in masses with the 



THE NEW MEDICAL WORLD. 199 

terminal blood vessels and form papillae or little elevations in the 
palm of the hands and the fingers and also in the lips where the sense 
of touch is exceedingly delicate. Blind persons are taught to read by 
passing their fingers over raised letters. Owing to the absence of 
sight the sense of touch becomes more highly developed so that 
they can distinguish coins, transact business and do many kinds of 
work which would seem impossible without sight. 

The lymphatic vessels are abundant in the skin ; they absorb a 
certain portion of waste liquid material and convey it back to the 
circulation. Here nature shows her economy by casting off that 
which is poisonous and for which she has no further service and 
re-using all that can be of any further aid to the system. 

The skin, upon close inspection, as we have already seen, is found 
to contain little lines or furrows and elevations, which are composed 
of a minute artery and vein, or blood points, and the meshes of the 
nerves of touch already referred to. These elevations are called 
papillae, and are very minute and abundant, the tip of the finger 
containing several hundred. On account of the existence of these 
papillae in the external portion of the true skin, that portion is some- 
times called the papillary layer. 

The study of the skin in general is of great interest. It forms a 
wonderfully efficient, intricate and beautiful covering for the body, 
without which man would be incapable of communicating with the 
world about him. So necessary is the scarfskin to our existence 
and to the well being of the structures beneath it, that existence 
could be maintained only a few hours without it. The skin regulates 
all the impressions made upon the body by the world around us, and 
in health enables us to receive these impressions without distress and 
transmits them to the brain. Thus we become conscious of the 
world around us and the properties of material things. 

The millions of pores of the skin stand ever ready to do their 
important work in the elimination of effete material and the regula- 
tion of the temperature of the body. The skin is in full sympathy 
with the lungs, the kidneys and other organs of the body, and aids 
as is necessary in the performance of their work. In fevers, almost 
the first sign of improvement is manifested by the activity of the 
skin. 

The skin is subject to a great variety of diseases, some of which 
are of serious import. These we will consider as their importance 
requires. Every intelligent person should be interested in this sub- 



200 THE NEW MEDICAL WORLD. 

ject. If ladies would give more attention to this complex organ they 
would be unwilling to cover the face with injurious lotions and 
powders, which in the end can only harm the delicate bloom of the 
complexion they are so anxious to preserve. 

Not only is the skin subject to a great variety of diseases, but it 
shares in all the disarrangements of the system. Fever disturbs its 
functions, also indigestion, congestion of the liver, the eating of cer- 
tain unwholesome foods, and the use of certain medicines. Before 
entering upon the special diseases of the skin some general remarks 
will enable us to comprehend the subject more fully and render the 
consideration of skin diseases more satisfactory. 

II.— MANAGEMENT OF THE SKIN. 

The skin requires considerable attention to preserve it in a healthy 
condition. Its structure is complex as we have seen, its functions are 
various hence it is liable to become disordered by a great variety of 
causes. Many diseases of the skin if not caused are certainly aug- 
mented by an improper diet and in the management of the skin the 
question of food in its relation to health stands first. 

There are many conflicting ideas with respect to diet which we shall 
not attempt to discuss. It is sufficient to say that food should be 
adequate in quantity and of suitable variety and quality. It seems 
probable that in this country at least more persons are over than 
underfed and that on the whole too much meat and heating food is 
consumed. Those afflicted with skin affections should pay particular 
attention to the diet and avoid greasy food, rich gravies and pastry. 
Moderation is as essential in eating and drinking as in labor either of 
body or mind. 

It is possible to eat too much meat thereby clogging the portal cir- 
culation and obstructing the various outlets of the eliminative Bys- 
tem. This acts unfavorably upon the skin and gives it a muddy ap- 
pearance if it does not contribute to more marked disturbances. 

Tea and coffee do not improve the complexion, and if used should 

be of good quality and employed moderately. Vegetables arc essen- 
tia] to health as they contain various chemical properties which are 
required to keep the system and especially the >kin in a healthy 
condition. Scurvy never breaks out unless the diet is deficient in 

this respect. 

A variety of ripe traits may be regarded as conducive to health. 



THE NEW MEDICAL WORLD. 201 

Beer drinking is unfavorable and will certainly injure the complexion 
if persisted in. Alcoholic spirits cause congestion of the capillary 
blood vessels of the face, and unduly stimulate the sweat glands, and 
are objectionable on this score as well as on many others. 

Avoid especially over indulgence at night. Do not eat heartily 
enough to spoil the appetite for breakfast. A poached egg or two, 
or a slice of lean cold roast, with a baked potato, a slice of stale bread 
or toast or fruit sauce, ought to be a sufficient meal for the close of 
the day. More than this overtasks the eliminative organs and works 
detrimentally. 

There is one other important matter associated with the care of 
the skin, and that is cleanliness. The surface of the body is not only 
exposed to dust and dirt, but the evaporation of the perspiration 
leaves upon it a residum of salts and fatty matter which requires fre- 
quent removal to prevent an offensive odor from the person. In 
addition to this, scales of epidermis are being constantly exfoliated ; 
and all such dead and waste material should be removed. Cleansing 
requires the addition of a small amount of soap to the water, as the 
alkali acts upon the fatty waste material and accomplishes its removal. 

After this is removed, rinse the face, hands or body in pure water 
and rub till thoroughly dry. Friction is a valuable promoter of a 
healthy skin. Hot water is, for many reasons, preferable to cold for 
sponging the skin. It is beneficial to the complexion of the face. 
In some diseases, as acne and eczema, it also possesses curative 
properties. 

Outdoor exercise is beneficial to the skin. Do not be afraid of tan 
or freckles. 

The scalps of children should be kept clean. Do not allow scurf 
and dirt to accumulate. Water to which a little pulverized borax 
has been added will be found serviceable for removing dandruff ; do 
not use the costly washes advertised for sale, for they are no better 
than water to which a little alcohol has been added. 

When skin diseases exist they should always be cured if possible. 
Health is always preferable to disease. There is no more danger in 
curing diseases of the skin than there is in curing disease in any other 
part or organ of the body. 

Children of low vitality should not be bathed or immersed in cold 
water. A warm sponge or towel bath is much preferable. The parts 
liable to chafe may be dusted, after bathing and drying, with rice or 
talc powder. 



202 THE NEW MEDICAL WORLD. 

IH._COSMETICS. 

If these were essential to health or even good looks there would 
be some excuse for their use. It is known that they do not make 
the skin fair nor improve its condition in any respect but do just the 
opposite, for they extract from it oil, rendering it faded, wrinkled, 
dry, chapped, sallow and unhealthy, and hence after awhile injure 
the complexion and it would seem as though no one could be induced 
to make use of them. 

Those which contain lead or mercury are poisonous because these 
minerals cannot be used without being absorbed into the system 
more or less and without doing injuiy to the skin and destroying its 
natural qualities. It is impossible to use cosmetics and conceal the 
fact from the eye of any person who has any keenness of perception. 
This last fact should deter any sensible person from their employ- 
ment. 

The following is a non-poisonous mixture which can be prepared 
by any good druggist, and when the use of cosmetics is considered 
necessary to cover over some natural blemish is recommended on ac- 
count of its being safe and free from deleterious substances. 

I£ Wheat starch four drams 

Zinc oxide half a dram 

Magnesia carbonate four grains 

Red carmine one grain 

01 rose three drops 

Mix. Apply as needed. 

It should be remembered that beauty does not consist in a painted 
face. Beauty lias been defined by a recent writer as intelligent ex- 
pression combined with refined manners, pure skin, healthy bloom, 
sparkling eye, pearly teeth and smiling lips. 

IV.— GENERAL OBSERVATIONS ON DISEASES OF THE 

SKIN. 

There are in all about sixty distinct diseases of the skin enumer- 
ated, a few of which are important from their frequent occurrence. 
Others are less important because rare, and in this work deserve only 
a pa>->in<_i- mention, while many others are more properly omitted. 



THE NEW MEDICAL WORLD. 203 

Some skin diseases are well known and easily recognized by any 
experienced person. Still a greater number are so rare that the busy 
practitioner, outside of the large cities, scarcely ever sees them. Many 
diseases of the skin, as might be supposed, are so mild as to cause 
but little disturbance, and are without danger, while others may be 
formidable, obstinate or perhaps malignant. 

In nearly all acute diseases and inflammations the skin manifests 
sympathetic symptoms of the affection to a greater or less extent. In 
the acute stage of scarlet fever the skin is hot, dry, red and itchy, 
and the exfoliation which takes place after recovery proves how 
great was the disturbance of this organ. 

As we have seen, the skin is very liberally supplied with sensitive 
nerves. It is owing to this fact that injuries like burns and scalds 
even though superficial, when a large extent of the surface is involved, 
often prove fatal. The nervous system is liable to suffer from shock 
when any powerful impression is suddenly made upon it. 

When a person is overheated and all the pores of the skin are di- 
lated or relaxed, a cold current of air striking the body produces a 
violent impression upon the cutaneous nerves and perhaps tempora- 
rily paralyzes them, or else the shock is transmitted to the great 
nerve centers which control the processes of organic life. A cold, a 
fever or congestion of some internal organ may result. Many a fatal 
sickness has had its beginning in a current of air after the manner 
described. 

In a similar way the nervous system may be shocked by the exces- 
sive drinking of ice water when overheated and occasionally the 
shock is said to have been sufficient to produce death. Fatal results 
have sometimes followed a blow upon the abdomen, apparently of 
insignificant force but sufficient to startle and paralyze the nerve cen- 
ters. 

Sudden checking of the perspiration, apparently trivial, often pow- 
erfully impresses the nervous system, throws it into a state of shock 
and it is in this manner that those grave results are brought about 
which are attributed to catching cold. An entire arrest of the func- 
tions of the skin would prove speedily fatal. In reality this never 
occurs but to a partial arrest of these functions a vast number of se- 
rious complaints as catarrh, pleurisy, bronchitis, croup and many others 
can often be attributed. 

When the secretions of the skin are partially arrested extra labor 
has to be performed by the lungs, the kidneys and all the eliminative 



204 THE NEW MEDKA1. WORLD. 

organs. If at such a time there is weakness or disease of these com- 
pensating organs the danger is much increased. 

It is an old notion that skin diseases are due to impurities of the 
blood ; this notion though false is so strongly intrenched in the 
minds of the people that a statement of the truth stands little chance 
of being believed. Another old fallacy is that eruptions upon the 
skin should not be too speedily cured. Effort should be made to 
cure eruptions upon the skin with as much promptness as disease of 
any other part or organ. 

Before entering upon a description of particular skin diseases, a 
few general observations will assist much in a complete understand- 
ing of what follows, and render it possible for the uninitiated to 
diagnose the more common skin affections. 

A red spot, or blush, upon the skin is due to an excessive blood 
supply in the capillaries; it may be temporary or permanent. Blush- 
ing is temporary, and due to a slight shock of the vasomotor nerves of 
the face, by means of which shock or temporary paralysis the blood 
supply of the capillaries is momentarily increased and the blood 
rushes in and distends them to the extent of their capacity. Bella- 
donna may be given in sufficient doses to paralyze for the time being 
the cutaneous nerves which regulate the blood supply of the capill- 
aries and produce a pink blush upon the skin. 

In scarlet fever the poison of the disease probably paralyzes the 
tropic cutaneous nerves, hence the skin is hot, dry and flushed from 
an excessive blood supply. 

A red spot upon the skin, due to hyperemia, is known as erythema, 
but when the spots are small they are sometimes called roseola. 

The term papule (a pimple) is applied to small, inflammatory ele- 
vations of the skin the size of a pin head, and sometimes a little 
Larger. When the diameter of a papule is about one-third of an inch 
or more it is then known as a tubercle. A tubercle is smaller than a 
tumor. 

Vesicles are little cone-shaped elevations which contain a straw- 
colored fluid ; they usually cause itching. 

PUstules are small elevations which contain pus or matter. A 
vesicle may become a pustule at a later Stage. 

Tumors vary in size from a hickory nut to a goose egg. A tumor 

is i general term which is applied to any swelling or growth, as a 

wen or cancer. 

Scales are flakes of dried epidermis. In some inflammatory affeo- 



THE NEW MEDICAL WORLD. 205 

tions, especially after scarlet fever, their proliferation is abundant. 

Excoriations are portions of the skin denuded of epidermis by 
scratching, friction, some slight injury or otherwise. 

Crusts are composed of fluids which dry and harden after exuding 
from an inflamed surface. In infantile eczema such crusts are abun- 
dant, hence the name milk crust. They vary in size and shape and 
their contents are serum, pus and blood. When they are composed 
of blood they are dark colored, when of serum alone they are yellow. 

Fissures are cracks in the skin which vary in length and depth, 
situated about the corners of the mouth, nose, ear, neck, tips of the 
fingers, soles of the feet, bends of joints, and in folds of the skin sub- 
ject to motion and tension. They are often quite troublesome and 
painful, and interfere with the natural movements of the parts to a 
greater or less degree. 

Ulcers are destructions of a portion of the skin due to suppuration 
or the formation of pus. They vary in size, depth and appearance. 
The}^ result from various causes, as diseases or injuries. A simple 
ulcer tends to heal readily. Chronic or indolent ulcers are more 
difficult to heal. Malignant ulcers possess a sloughing and gangre- 
nous character, and the destruction of the diseased tissue is essential 
to the healing process. Unless this can be accomplished the destruc- 
tive process continues till vital organs are involved. 

Scars are new tissues resulting from burns, scalds, wounds, ulcers 
and numerous injuries. They are usually painless and they vary as 
much as do the injuries by which they are caused. 

Skin diseases are usually classified by authors, and such classifica- 
tions are numerous. If simple, they are an aid to the student, but 
no classification would help the readers of household medicine, since 
so many affections treated in technical works are here omitted. 

It is well, however, to bear in mind that certain affections of the 
skin are due to disorders of the glands, others are due to inflamma- 
tory action, while others are due to vegetable or animal parasites. 

It is well to bear in mind that syphilis causes disturbances of the 
skin to a remarkable degree. 

Y._ DISORDERS OF THE SWEAT GLANDS. 

There may be lack or excess of perspiration, or there may be 
offensive odor to the perspiration and these may exist to such an 
extent as to require treatment. 

Absence of perspiration causes a dry and unnatural condition of 



'2U() THE NEW MEDICAL WOELD. 

the skin which is greatly relieved by the application of olive oil or 
vaseline to the surface. This is liable to occur in the early or hot 
stages of fevers in diabetes and albuminuria. Suitable for absence 
of perspiration are vapor or hot baths followed by the application of 
oil- to the surface of the body. 

Excessive perspiration may cause weakness and exhaustion. It is 
very rarely that death is caused by the exhaustion from excessive 
perspiration. Excessive perspiration often occurs in rheumatic and 
malarial fevers, in pyaemia, consumption and at times in some other 
affections. When this condition exists much relief is obtained by 
sponging over the body with alcohol and water and a complete change 
of clothing. 

The excessive perspiration of certain portions of the body as the 
palms of the hands, soles of the feet, the armpits and groins is 
often troublesome. This condition is rendered especially annoying 
when attended by offensive odors. 

The treatment consists in frequent bathing of the parts with cleans- 
ing lotions, as for instance water to which a small amount of per- 
manganate of potash sufficient to give to it a crimson tinge has been 
added. Frequent ablutions of the feet are needful and when this 
does not prevent the detection of unpleasant odors a little borax, two 
teaspoonfuls, may be used in the foot bath and a little boric acid 
dusted into the stockings which are to be worn only for a single day 
without change. For offensive perspiration sulphur taken internally 
Is highly recommended. The following is reliable. 

I£ Pulv. sulphur precip. two drains 

Pulv. chalk comp. four drams 

Pulv. cumin comp. two drams 

Mix. Take a level teaspoonful in water each night and morning. 

Where the perspiration is general instead of being confined to 
sonic local region atropia sulphate is an excellent remedy. A tablet 
containing y, 1 ,^- of a grain should be taken each night and morning, 
the dose being increased, as toleration is established, to -fo of a grain. 
or perhaps more. 

A wash, containing astringents, as alum and tannin, is harmless, 
and may be used to check temporarily excessive sweating of the arm- 
pits. For the most part disorders of the sweat glands are due to 
diseases of internal organs, which should receive appropriate treat- 
ment. 



THE NEW MEDICAL WORLD. 207 

Excessive perspiration may cause in infants a condition known as 
prickly heat. It is the result of hot weather, combined ^\ith an 
excess of clothing. The body should be sponged over with soda or 
borax water; two teaspoonfuls of borax or soda is sufficient for a 
bath, and heavy clothing exchanged for that of a lighter character. 

What is called the red gum of infants is of the same nature as 
prickly heat, and requires similar treatment, viz.: a light, bland diet, 
light clothing and cooling or saline drinks, as citrate of magnesia, 
occasionally, until quite free action of the bowels is secured. 

A bland dusting powder, as the following, is beneficial : Oxide of 
zinc and starch, equal parts, dusted over the surface, or the stearate 
of zinc with boric acid. 

VI.— DISORDERS OF THE SEBACEOUS GLANDS. 

1. Seborrhea, or Dandruff. 2. Wens or Tumors of the 
Scalp. 3. Baldness or Alopecia. 

Seborrhea. — Seborrhea is an affection which may occur on all 
parts of the body supplied with sebaceous glands. The cause of 
seborrhea is unknown, but it is supposed to be due either to an 
excessive or an altered secretion of sebaceous matter. There are two 
general varieties of this affection, one dry and the other moist, but 
both contain the evidence of oil either in fluid or solid form. Moist 
seborrhea is common on the face of young persons, especially those 
of dark complexion, to whom it gives a glossy or greasy look. 

Dry seborrhea is a very common affection of the scalp known as 
dandruff, the hair being filled with immense numbers of fine epithe- 
lial flakes, apparently dry, but always oily. Moist seborrhea of the 
scalp is often seen in infants, if bathing is imperfectly performed. It 
appears as crusts upon the top of the head, upon which dust collects, 
giving to the scalp a dirty, scabby appearance and a rancid odor. 

Dry seborrhea, of which there are several varieties, requires the 
more especial attention, on account of its liability to injure the lustre 
and nutrition of the hair and cause it to fall out. It is one of the 
most frequent causes of premature baldness. 

Dry seborrhea of the scalp and loss of hair are frequently caused 
by acute diseases, as fevers, and such loss of hair may be temporary 
or permanent. Dry seborrhea of the scalp often causes a mild grade 
of itching, but usually there is no inflammation of the skin which is. 



208 THE NEW MEDICAL WOBLD. 

found to be quite healthy beneath the dandruff. Unless the fine 
scales are very abundant or the hair falls out freely but little atten- 
tion is given to this common affection. 

TREATMENT. 

This is apt to be tedious, the affection frequently lasting for years. 
Sometimes there exists a debilitated condition of the general system 
which requires appropriate treatment. Gastric troubles should be 
remedied and tonics administered according to the needs of each 
particular case. 

For seborrhea of infants it is necessary to soften up the crusts by 
the application of sweet oil or vaseline and then to wash the head 
thoroughly with castile soap and warm water, or with a solution of 
glycerine, borax and water or buttermilk may be used. 

External remedies are beneficial to soften the secretions and aid in 
their removal, to improve the general condition of the skin and to 
prevent the reappearance of the affection. Dry seborrhea will be 
benefited by the following : 

fy Sulphur sublimed twenty grains 

Thymol fifteen grains 

Vaseline one ounce 

Oil bergamot one-fourth of a dram 

Mix. Rub some into the scalp each night. 

After washing and cleansing the head thoroughly with soap and 
water or the borax and glycerine lotion the following may be used : 

I£ Corrosive sublimate one grain 

Rose water one dram 

Vaseline four drams 

Oil of sweet almonds two drams 

Mix, and rub a little into the scalp every night. 
This affection is apt to recur. 

Wens or Tumors of the Scalp. — A wen is a sebaceous tumor, 
occurring most Frequently upon the head. A wen may be due to 
obstruction ot the outlet of a sebaceous gland, and it-* secretion being 
retained Forma a tumor of varying size. 

The contents of a scltaceotis tiiiuor may vary. It is sometimes 



THE NEW MEDICAL WORLD. '20 ( J 

solid and sometimes fluid. A degeneration may occur when the 
tumor softens and suppurates, the contents finally escaping by ulcera- 
tion. These growths are sometimes mistaken for cancers. 

TREATMENT. 

This consists in removal. An incision should be made into the 
tumor and the accumulated material removed together with the sack 
which surrounds it. A small wen can sometimes be squeezed out by 
the thumb and finger, using sufficient pressure. The risk of removing 
a sebaceous tumor is very slight. Cancerous tumors of the skin are 
included under the general subject of cancer. 

Baldness or Alopecia. — Baldness of a whole or even a small part 
of the head is never desirable. It is usually regarded as a sign of 
approaching age, but this is not necessarily so, for many persons are 
more or less bald before reaching forty years. In some families 
baldness comes on at an early period. It may occur in persons 
otherwise healthy, and in such cases it is often due to hereditary 
tendency. 

There are several varieties of baldness, as congenital, presenile or 
premature, and baldness due to some affection or mismanagement of 
the scalp. 

Congenital baldness is usually unimportant, as in most cases it 
exists only for a limited time, and does not require treatment. Chil- 
dren born without hair usually develop a growth of it in at least one 
or two years without treatment. 

Senile baldness, or that of old age, is another form about which but 
little is necessary to be said. After forty-five or fifty it may be 
expected that the hair will get thinner and baldness appear on the 
dome or crown of the head. Senile baldness cannot be remedied to 
any great extent. It may in some instances be delayed by treatment, 
but a cure cannot be expected. 

Premature baldness may be regarded as that which occurs prior to 
forty years of age. It is much more common in civilized than in 
savage or primitive life and is also much more frequent in men than 
women. 

Xaturally the hair falls out and is renewed quite frequently, as 
often as two or three times a year, and unless sufficient renewal takes 
place baldness will finally ensue. Premature baldness may be due 
to a variety or a combination of causes. 



210 THE NEW MEDICAL WOULD. 

Among the prominent causes of this affection heredity is regarded 
as taking foremost rank. It is not uncommon to find families from 
father to son manifesting this tendency in a marked degree, and that 
such a tendency should exist is no more strange than a similarity 
in other respects as looks, voice, gesture, build, etc. 

Another cause of premature baldness is atrophy or disease of the 
hair bulbs resulting perhaps from acute fevers of a severe type, ery- 
sipelas, gout, leprosy, syphilis and seborrhea. When syphilis is the 
cause of alopecia proper treatment usually succeeds in the restoration 
of the hair. The treatment in every case depends to a large degree 
upon the cause which produces the affection and upon the manage- 
ment of the scalp. 

Preventive treatment is much more successful than curative and 
hence it is that the care of the hair is of special importance. 

The hair needs for luxuriant growth light and air ; the wearing of 
stiff, unventilated hats is detrimental to its health. The hats of 
women are less injurious than those of men, they do not press heav- 
ily upon the head, but being light and small admit the air and sun- 
light. This accounts also to some extent for the difference between 
civilized and primitive life. 

It is said that hot curling irons and crimping the hair upon papers 
is not a harmless process, as it usually in time injures the hair. 

Constant mental strain and worry are said to cause baldness. 
Working under artificial lights which emit a perceptible amount of 
heat is said to be detrimental. Too much wetting of the hair is also 
injurious. 

When the head needs cleaning a borax solution does its work well 
but should not be repeated too often. After washing the scalp it 
should be thoroughly dried and if necessary oiled with a small amount 
of vaseline or almond oil. When the hair is properly brushed it will 
require but little oil to keep it in a healthy condition. The hair should 
be exposed to the air and sunlight for they are the natural stimulants 
of the scalp. Hair restoratives containing lead are poisonous and 
should not be used. 

Of all the causes of premature baldness dandruff occupies a promi- 
nent place ; it does not always occasion baldness but does in a large 
Qumber of cases. The scalp is itchy, there are a large number of 
scales which fall upon the clothing, the hair is dry and falls easily 
and rapidly. It is noticed that the hair gets thinner, especially upon 
the top of the head and crown. For premature baldness caused by 



THE NEW MEDICAL WORLD. 'ill 

dandruff sulphur is regarded as the most important remedy. No 
satisfactory domestic line of treatment can be well detailed for these 
affections, as many remedies are suggested by eminent authority and 
the skill of the practitioner is usually required to select the appropri- 
ate means for individual cases. A few only of the more efficient and 
usual remedies can be suggested at this point. 

For the prevention of baldness the following claims high sanction : 

^ Sulphur precip. thirty to sixty grains 

Vaseline one ounce 

Oil bergamot one- fourth of a dram 

Mix, and apply to the scalp every night for three weeks, then give 
the scalp a thorough washing, after which apply every other night 
for three weeks more, and then gradually taper off its use as sug- 
gested by the progress of recovery. If the sulphur irritates the scalp 
use olive or almond oil in its place till the irritation subsides. Only 
a small quantity of the above prescription should be used at one time, 
and the treatment often needs to last for several months or a year. 

In the same line of cases and to be used in about the same manner 
is the following : It is said to be an excellent formula, to be used 
preventively, in mild forms of dandruff, before baldness becomes an 
actual fact : 

I), Ammoniated mercury twenty grains 

Mild chloride of mercury forty grains 

Vaseline one ounce 

Mix, and apply two or three times a day. 

The following lotion has been used with success : 

^ Quinine one half dram 

Acid sulphuric aromat. one half dram 

Tinct. cantharides one half ounce 

Myroxylon one dram 

Cologne water eight ounces 

Mix, and apply three times a day to the scalp. 



212 THE NEW MEDICAL WORLD. 

The following is a lotion of a more stimulating character, and 
works well in selected cases : 

1£ Alcohol one ounce 

Tinct. cantharides two drams 

Tinct. capsicum two drams 

Spirits rosemary ' one ounce 

Strong spts. of ammonia one ounce 
Mix, and apply twice a day. 

VII.— ACNE AND COMEDO, 

OR FACE PIMPLES AXD BLACKHEADS. 

Acne is a very common disease of the skin especially annoying to 
young persons after the fourteenth year. It exists in several forms 
upon the face, neck and chest. The most common form is an erup- 
tion of pimples varying in size which are succeeded by renewals of 
the affection so that its duration is uncertain. The pimples may or 
may not contain pus. The pus may be superficial or deeply seated. 
When the latter condition exists the swelling is often quite large and 
the amount of inflammation considerably increased. 

Comedo or blackhead is the name applied to acne when there is 
no inflammation, redness and swelling. In this form the sebaceous 
glands are filled with a semi- solid cheesy substance and dust lodging 
in the depression at the opening of the sack causes the resemblance 
to a worm or grub. This resemblance is very striking when the con- 
tents of the gland is pressed out. In addition to pimples whiskey 
drinking causes a dilation and congestion of the capillary blood ves- 
sels about the nose and this disorder is called acne rosacea. 

CAUSES. 

The sebaceous glands have been described elsewhere. They open 
by a little duct into the hair follicles close to a bulb or root of the 
hair. This secretion prevents the hair from getting dry. Upon the 
face these glands open upon the surface of the skin and prevent dry- 
ness or chapping. When the sebaceous glands are active the fluid 
they secrete is constantly poured out in a normal manner. There is 
then no formation of pimples but when the secretion is retained in the 
sack or becomes hardened, the sack becomes distended and in order 
to get rid of it nature sets up an inflammation about the gland. 
Comedo is the name of the retained secretion before it has excited 



THE NEW MEDICAL WORLD. *213 

inflammatory action hence it is really but one stage of the affection. 

The cause of acne then must be due to an altered condition of the 
sebaceous glands so that their functions are disturbed. This altered 
condition results either in an excessive secretion of sebaceous matter 
or else in its being hardened and retained in the sack until it excites 
some inflammatory action. 

The causes of acne must be sought for back of the inflammation 
which results in pimples, swellings and the formation of pus. These 
causes are somewhat obscure but among them are a sluggish circula- 
tion, a disordered liver and constipation. Alcoholic excesses, dis- 
order of the sexual organs and nervous changes taking place in the 
system at puberty, errors in diet as overeating, the eating not only of 
too much but too rich food, especially the consumption of fatty foods, 
close habits of study causing too much indoor confinement, bad hy- 
gienic surroundings in general and a sluggish condition of the elimi- 
nating organs. Several of the above causes probably combine in 
every case of this affection to produce the changes in the functions 
of the skin which are characteristic. » 

TREATMENT. 

The treatment is often unsatisfactory and ought to be carried on 
for some time. When the cause of the disorder can be ascertained 
it should be removed, if possible, by appropriate measures. Improve 
the general condition by hygienic measures, as exercise and bathing. 
Regulate the digestive functions and correct derangements of the 
nervous system. Avoid highly seasoned and indigestible articles of 
food, also stimulants, as beer and alcoholic drinks. Tonics contain- 
ing iron, nux vomica and arsenic mav be essential. The following 

O ' t/ O 

pill may be used with benefit. As it contains active poisons care 
should attend its use : 

]J Reduced iron ten grains 

Strychnia one-fifth grain 

Arsenious acid one-fifth grain 

Mix, and divide into twenty pills. Take one pill three times a 
day, after meals. At the same time local treatment must be made 
use of, and chief reliance must be placed upon it. It is necessary to 
squeeze out the black heads with the fingers or a watch key, and a 
little practice will render the process rapid and almost painless. 
Pimples that have festered should be pricked with a clean steel 



214 THE NEW MEDICAL WORLD. 

needle and their contents pressed out with the fingers. Bathe the 
face every night and morning with hot water, as hot as can be used 
without burning it. This is of great benefit in bringing about a 
healthy condition of the glands. 

The following are some of the best prescriptions known to the 
profession, and either of them can be selected and used according to 
directions : 

g, Naphthol one dram 

Sulphur precipitate five drams 

Vaseline two and one-half drams 

Green soap (German) two and one-half drams 

Mix, and spread some of this on the skin daily for ten minutes, 
then cleanse the face and dust on talc powder. 

^ Sulphur sublimed thirty grains 

Thymol three grains 

Zinc, oleate one scruple 

Vaseline one-half ounce 

Mix, and apply to the face each night, cleansing the face thor- 
oughly in the morning. If the remedy inflames the skin, it must be 
omitted for a few days and then its use again commenced. 

The following is a stimulating lotion recommended by high author- 
ity: 

1^, Green soap (German) two ounces 

Rectified spirits of wine one ounce 

Dissolve the soap in the spirits then strain through a muslin cloth 
and add : 

Spirits of lavender two drams 

Mix, and bathe the face with this each night and morning. 
The following prescription is much used in Germany : 

5, Sulphur precipitate two drams 

( lamphor ten grains 

Gum arabie twenty grains 

Lime water two ounces 

Rose water two ounces 

Mix, shake the bottle well and apply to the face at bed time ; in the 
morning remove the sulphur without wetting the skin. 

Other remedies are made use of by the surgeon in Stubborn cases. 



THE NEW MEDICAL WORLD. 215 

VIII.— MILIUM. 

Milium is the name applied to certain small white points or tumors 
seen imbedded in the skin of the face especially about the angles of 
the eyes. 

They vary in size from a pin point to a pin head and get their 
name from their resemblance to a millet seed. These little tumors 
are similar to those larger ones which sometimes appear in the Mei- 
bomian glands of the eyelids. 

The treatment of these little tumors is simple and consists in their 
removal. This is accomplished by means of a small incision and by 
the application of sufficient pressure to force out the little hard, white 
globular substance. 

IX.— PRURIGO, ITCHING OR PRURITUS. 

Itching is a symptom of several skin diseases but it may exist as a 
separate affection and is often an important and troublesome condi- 
tion. It is often worse at night when the patient gets warm in bed 
and may be so severe as to disturb or even prevent sleep. It may be 
general and extend over the whole surface of the body or local and 
confined to some particular area. It is frequently very annoying 
about the anus or genital organs and so obstinate as to resist for a 
long time the best directed treatment. This affection is augmented 
by scratching and the skin is liable to become thickened or take on a 
chronic condition resembling eczema. 

In order to treat pruritus successfully it is necessary if possible to 
ascertain the cause on which it depends. Unless the cause can 
be ascertained the treatment is likely to fail altogether. It is some- 
times due to the change from warm to cold weather or to wearing 
woolen underwear. It may result from certain diseases of the liver, 
kidneys or nervous system or from constipation or piles. Disorders 
of menstruation and the condition of pregnancy sometimes favor the 
development of this affection. It is sometimes due to disorders of 
digestion, to intestinal worms or to some disturbance of the nervous 
system. 

TREATMENT. 

Whenever pruritus is due to any of the above causes they should 
receive appropriate attention. The diet should be regulated ; strong 
tea, coffee, highly seasoned dishes and alcoholic stimulants should be 
avoided. Easily digested, wholesome food, a proper amount of ex- 



210 THE NEW MEDICAL WOULD. 

ereise in the open air and soft underwear should be prescribed. 
Local treatment consists in hot water baths containing borax, car- 
bolized lotions and ointments. A lotion made by pouring a pint of 
boiling water upon two drams of leaf tobacco is said to be of consid- 
erable virtue. 

The following is an excellent lotion : 

r), Acid carbolic one or two drams 

Alcohol one or two ounces 

Aquae one pint 

Mix. This makes an excellent external application. 

The following will often give prompt and decided relief: 

r> Menthol thirty grains 

Alcohol one ounce 

Mix, and apply externally as needed. 

The following ointments may be used: 

r> Naphthol one dram 

Vaseline one ounce 

Mix, and apply externally, or: 

r> Menthol thirty grains 

Vaseline one ounce 



Mix, and apply externally as needed 
Th 
relief 



The following ointment containing cocaine is said to afford marked 



r), Cocaine fifteen grains 

Vaseline one ounce 

Mix, and apply as needed. 

For interna] treatment a tablet containing T( 1 ln grain of atropia sul- 
phate maybe taken twice a day. .Many other' remedies have been 
used, but for ordinary eases no better remedies can be prescribed 
than those already suggested. When the trouble does not yield to 
these remedies it will be necessary to consult some one who gives 
especial attention to disorders of the skin. 

X.— SHINGLES OR HERPES ZOSTER. 

This i^ an acute disease characterized by neuralgia pain and the 
formation on the surface of groups of vesicles over the line ^i certain 
i rves. 



THE NEW MEDICAL WORLD. 217 

CAUSES. 

The following are regarded as the usual causes : exposure to cold, 
the sudden checking of the perspiration and the irritation, compres- 
sion or injury of a nerve ganglion or nerve tract. The injudicious 
use of arsenic medicinally has been thought to give rise to this affec- 
tion and there are probably other obscure causes. 

SYMPTOMS. 

Pain either mild or severe is the first symptom. The pain is of a 
neuralgic character accompanied by a sensation of smarting, burn- 
ing or throbbing and sometimes persistent itching. The next symp- 
tom is an inflamed condition of the skin in patches on one side or 
half of the body, following the line of some nerve, commonly the in- 
tercostal, extending from the spine along the line of the ribs to the 
median line in front. Upon this inflamed and reddened surface 
groups of vesicles begin to form about the size of a pin's head which 
increase in size until they are as large as a pea. This process goes 
on for five or six days. Within these vesicles is a yellow fluid which 
at length dries away. This affection usually appears but once dur- 
ing a lifetime and is especially troublesome when it attacks aged 
persons. Its duration is indefinite varying from ten to twenty days 
or more. Vesicles which form about the lips, nose, forehead 
or face after fevers and attacks of malaria are forms of this 
disease. They are known as fever sores or cold sores and 
receive different names depending upon their locality. They 
sometimes attack the genitals, 

TREATMENT. 

Internal remedies seem to do but little good. Herpes about the 
lips can often be aborted by applying to them in their beginning- 
strong camphor, pure cologne water, or a solution of carbolized 
water or vaseline. It is necessary to abstain from rubbing them, 
which hastens and favors their development. 

The strength of the carbolic solution should be twenty grains of 
the acid to the ounce of water or vaseline. 

For herpes upon the body oxide of zinc ointment makes a good 
dressing. To an ounce of this may be added cocaine, ten grains, or 



218 THE NEW MEDICAL WORLD. 

menthol fifteen grains. Or the following may be used and relieve 
the pain and itching, and its application is soon followed Ity a cool 
sensation : 

fy Menthol one dram 

Alcohol one ounce 

Mix, and apply as needed for relief. 

If a more soothing application is needed use the following : 

$ Extract belladonna ten grains 

Extract stramonium ten grains 

Extract opium ten grains 

Vaseline one ounce 

Mix, and apply as needed. 

Warm poultices, containing poppy heads or belladonna leaves are 
said to afford relief. A Dover's powder may be needed to relieve 
pain ; five or ten grains at night. 

XL— ECZEMA, TETTER, MILK CRUST OR SALT RHEUM. 

Eczema is the most common of all skin diseases. It is an acute 
inflammatory affection much inclined to take on a chronic condition. 
It presents many stages and varieties and for this reason is some- 
times difficult to diagnose. It may appear upon any part of the 
body, but is more common about some portion of the face or scalp. 

The skin is somewhat reddened and an eruption of vesicles appear 
from which there is a copious flow of serum or weeping. The dry- 
ing of this serum forms crusts, which cause sometimes an unsightly 
appearance. The disease is accompanied by intense itching, and if 
the patient scratches the eruption the affection is aggravated and 
scabs form composed of serum, pus and blood. The skin becomes 
thickened if it lasts for some time and the disease takes on the 
chronic forms. 

Infantile eczema, also called milk crust, is one of the most common 
affections of infants. It is often obstinate and yields reluctantly to 
treatment. In some cases it covers a Large portion of the face or 
sealj). It has a preference for the region about the ears and nose, but 
may appear anywhere. Those eases in which the eruption covers 
the whole body are formidable, and in a few cases have proved fatal. 
Certain irritating substances favor its development. 



THE NEW MEDICAL WORLD. 219 

CAUSES. 

Teething is sometimes regarded as the cause of infantile eczema. 
It appears often to result from some fault in the process of digestion 
or nutrition. In adults certain occupations appear to favor its devel- 
opment. Washerwomen, grocers, masons and bakers are more prone 
to its development than others. Yet in many cases no assignable 
cause can be perceived. 

TREATMENT. 

The treatment of eczema often requires great care and patience 
and depends much upon the age of the patient, the stage of the 
eruption and its locality. In general, constitutional irregularities 
should be remedied ; dyspepsia, constipation and similar disturbing 
conditions should be relieved. 

In some cases internal remedies are necessary while in others local 
treatment may be sufficient. The oxide of zinc ointment is a mild 
and efficient remedy in mild cases ; it should be carbolized to allay 
itching, 

3 Oxide of zinc ointment one ounce 

Acid carbolic ten grains 

Mix and apply externally three- times a day. 

The following local application is efficient : 

5 Ungt. hydrarg. nitrate one dram 

Naphthol one-half dram 

Vaseline one ounce 

Mix and apply externally two or three times a day. 

In cases of long standing much benefit often follows the adminis- 
tration of Fowler's solution in connection with the above local reme- 
dies. Three or four drops after meals should be given to an adult. 
It should be diluted sufficiently with water. 

The following is a good formula for the administration of this val- 
uable tonic for the skin, 

1^, Fowler's solution one and one-half drams 

Elix. calisaya two ounces 

Comp. spts. of lavender two ounces 

Mix. Dose one teaspoonful after meals in a little water. 



'2'20 THE NEW MEDICAL WORLD. 

XII.— URTICARIA, HIVES OK NETTLE HASH. 

Tins is a common but mild inflammatory affection of the skin, 
characterized by the appearance of circular elevations known as 
wheals. They resemble the eruption caused by the bite of the mos- 
quito and other insects, or the sting of nettles. Itching is usually 
severe. This affection is very common with children, especially 
when taken to the seashore for the first time. In addition to the 
elevated circle and eruption, itching, tingling, burning and pricking 
are usually troublesome, while scratching aggravates the affection. 

It is usually worse at night, and a person troubled with urticaria is 
restless, and the sleep is much disturbed. In a sensitive skin slight 
irritation will often cause urticaria. It may be extensive, covering 
large portions of the body, disappearing and reappearing again for 
an indefinite period. Stomach disorders are often noticed in connec- 
tion with this affection, such as indigestion, and sometimes a mild 
grade of fever. In severe cases delirium, congestion, bounding pulse 
and high fever have occurred, suggesting meningitis or some brain 
trouble. These symptoms are temporary, and readily subside. 

CAUSES. 

It has been noticed that bottle-fed children, who are poorl}' nour- 
ished and who suffer from indigestion, are especially liable to attacks 
of urticaria. The causes of this affection may come from without or 
from within. Among the common external causes may be mentioned 
nettles, insect bites, friction of the skin, irritating clothing, chemical 
irritants, changes of temperature, the sea air and sea water. Among 
internal causes may be mentioned the use of the following articles of 
food : Muscles, shellfish, pork, canned meats, cheese, and certain 
fruits, as strawberries. There are a number of medicinal substances 
which may produce a rash upon the skin resembling urticaria. 

TREATMENT 

The digestion should be looked after and constipation remedied. 

Local treatment consists in hot alkaline baths, using soda or borax in 

the water. The Sopping upon the surface of alcohol and water, or 
alcohol, vinegar and water are recommended. Lemon juice may be 



THE NEW MEDICAL WORLD. 221 

rubbed over the eruption. Equal parts of linseed oil and lime water 
make a soothing application, and will be found very beneficial. 
Either of the following prescriptions may be used to advantage : 

I£ Soda bicarbonate two drams 

Acid carbolic half a dram 

Camphor water ten ounces 

Mix, and apply freely to the surface. 

!£, Zinci oxide two drams 

Spts. camphor three drams 

Goulard's extract one and a half drams 

Glycerine one-half ounce 

Water eight ounces 

Mix, and apply externally as needed. 

Internal treatment may require some mild laxative as the milk or 
citrate of magnesia, the former in teaspoonful doses. 
The following prescription is excellent : 

3, Sulphur praecip. one dram 

Cream of tartar twelve grains 

Mix. Divide into twelve powders. Dose, one three times a day. 
This can be obtained in tablet form and is more convenient to use. 

XIII.— PSOEIASIS. 

Psoriasis is one of the less common inflammatory affections of the 
skin, characterized by fine scales. Its cause is unknown. It has a 
great variety of manifestations, but usually begins as a red point, 
which increases in size, and becomes covered with a multitude of 
scales. The spot itself is usually circular in form and surrounded by 
a red marginal line. Under the scales the skin is red and unnatural. 
Its favorite locality appears to be about the elbow or knee ; it does 
not itch like eczema. Psoriasis is a chronic affection and likely to 
resist treatment. 

The skin under the scales usually becomes more or less thickened. 
When it attacks the palms of the hands and soles of the feet it is 
persistent and occasions' considerable inconvenience from cracks or 
fissures. Spring and fall are seasons of the year which appear to 
favor its development. 



222 THE NEW MEDICAL WORLD. 

TREATMENT. 

The internal use of Fowler's solution in three drop doses, taken in 
water after meals, has a more favorable influence upon psoriasis than 
any and all other remedies. Instead of this the, sulphide of arsenic 
may be taken in doses of T ^ F of a grain in pill form. Cod liver oil 
and the compound syrup of hypophosphites are also helpful in many 
cases. The following may be used externally with good effect : 

I£ Oil of cade one ounce 

Glycerine one ounce 

Alcohol one ounce 

Mix, and apply once or twice a day. 

IJ Sulphur sublimed four drams 

Oil of cade four drams 

German green soap one ounce 

Vaseline one ounce 

Precipitated chalk two and one-half drams 

Oil of lavender one-half dram 

Mix, and apply on a piece of lint. 

Many other remedies have been suggested and recommended, and 
in the hands of physicians are used as occasion requires for the treat- 
ment of psoriasis. Whatever remedies are made use of they must be 
persisted in for a long time. The following prescription is said by 
foreign authority to have cured when all other remedies have failed. 

J£ Bromide of arsenic one grain 

Alcohol two ounces 

Simple syrup eight ounces 

Mix. The dose is one teaspoonful two or three times a day. 

Bromide of arsenic may be obtained in tablet form in doses of ^ 
of a grain. These are very convenient. 

XIV.— LEPROSY. 

Leprosy is B chronic, contagions and incurable disease, somewhat 
resembling syphilis in its effects upon the skin, but, unlike syphilis, it 
does not yield to treatment. It is characterized by marked deformi- 
ties, unsightly growths, painful disturbances, and at last ends in 
death. 



THE NEW MEDICAL WORLD. 223 

It affects not only the skin, but the nervous and lymphatic sj^stem 
and other tissues, in all of which it develops morbid j:>rocesses. 

It is believed to be due to bacilli or rod- shaped, germs, but its 
method and law of development have not been discovered. It is not 
actively contagious, so that all danger of contagion can be averted 
by timely means. It originates in Eastern countries, and appears to 
thrive best in warm climates. Three forms of this disease are noticed 
but they all merge into each other. Leprosy can be stamped out by 
separating those having the disease from others. It is so rare an 
affection that a complete description of it is not essential. No treat- 
ment avails for its cure. 

XV.— LICE OR PEDICLTLOSIS. 

Three distinct species of lice find a habitation on the human body, 
head lice, body lice and crab, or pubic lice. The head louse is found 
only in the scalp. Its eggs are attached to the hair and are visible 
to the unaided eye. These eggs are popularly known as nits. Lice 
multiply rapidly and produce considerable itching, due to irritation 
of the scalp. Lice are often found in the heads of the untidy, and at 
school are liable to pass from one head to another. It is not unusual 
for them in this way to gain access to tidy families and to become a 
source of no little annoyance. 

TREATMENT. 

In children the hair may be cut short, the scalp thoroughly cleansed 
with soap and water, after which apply crude petroleum or kerosene 
oil ; two or three applications are sufficient. 

Mercurial ointment may be used thus : 

]$, Ammoniated mercury one dram 

Simple ointment or vaseline one ounce 

Mix, and apply externally a few times. 

The ammoniated mercury ointment is popularly known as white 
precipitate ointment. 

The following is efficient : 

1^ Beta naphthol one dram 

Vaseline one ounce 

Mix, and apply externally. 



% 1'1\ THE NEW MEDICAL WORLD. 

A lotion of alcohol will loosen the nits so that they can be removed 
by combing. The tincture of staphisagria applied thoroughly will 
effectually kill any kind of lice. This is a very simple and conven- 
ient method. 

For body lice apply a lotion as follows : 

]£ Acid carbolic one dram 

Water one pint 

The clothing should be put in boiling hot water or subjected to a 
high temperature. The eggs of the body louse are deposited in the 
seams of the clothing, where they may seen. Heating the outside 
garments and pressing the seams with a hot flat are among the 
successful means of getting rid of these troublesome parasites. 

The crab, or pubic louse, may be destroyed by applications of 
crude petroleum, kerosene oil or mercurial ointment. The nicest 
remedy is a lotion of corrosive sublimate with cologne, thus : 

$ Corrosive sublimate four grains 

Aqua cologne two drams 

Aqua four ounces 

Mix, and apply a few times externally. 

Ad ointment is made of staphisagria, or stavesacre, which is said 
to be very efficient for the destruction of lice and the itch-mite. It 
is used for other cutaneous diseases. It is not irritating, but this 
caution is essential, that it be applied only to the unbroken skin. 

XVI.— ITCH OR SCABIES. 

This is a contagious disease of an inflammatory character, due to a 
parasite, the acarus, also known as the itch-mite. This animal para- 
Bite is so small as to be hardly visible to the naked eve. The female 
itch-mile when transferred to a healthy person works her way down 
through the epidermis and burrows along forming a canal in which 
are deposited a number of eggs, and in a short time a new crop hatch 
out from these eggs. The disease in this way spreads, and more and 

more territory is successively involved. By means of the fingers and 

clothing the disease may be carried to other parts until, in neglected 
<-:iv,. s , nearly the whole body may be involved. 

The disease always lasts until the parasites causing it arc destroyed. 

The itch is chiefly a disease of the unclean poor, but may be con- 



THE NEW MEDICAL WORLD. 225 

tracted by any one. It is often troublesome in armies and on ship 
board, or where large numbers are congregated together with unfa- 
vorable surroundings. 

This affection usually begins in some sensitive part, especially 
between the fingers. The first thing to arrest attention is the per- 
sistent itching which characterizes the disease and gives it a name. 
Sometimes considerable irritation of the skin is noticed and, further 
irritated by scratching, papules and vesicles may form. The itching 
is worse at night, especially when the patient is in bed. 

TREATMENT. 

The disease may spread through an entire family before it is sus- 
pected, but fortunately it yields readily to treatment. 

It is necessary to destroy the parasite without injuring the skin. 
Sulphur has always been considered a specific for this affection, and 
it does not injure the skin in any way. 

The following is a good prescription unless the skin is very sen- 
sitive : 

]^ Sulphur pulverized two drams 

Potassa sub- carbonate one dram 

Lard one ounce 

Mix, and make into an ointment. This should be rubbed in at 
night over the whole portion of the body affected ; wash with soap 
and water in the morning. This treatment pursued for five or six 
nights will generally effect a cure. 

The following may be used in the same manner, and is more suit- 
able for a sensitive skin : 

I£ Sulphur flor. three drams 

Naphthol three drams 

Bals. Peru three drams 

Vaseline three ounces 

Mix, and make ointment. 

Out of the many prescriptions suggested these will prove satis- 
factory, and if directions are followed will effect a cure. 

In using these ointments for infants or persons of unusually deli- 
cate skin they may be reduced in strength by the addition of more 
lard or vaseline. 



220 THE NEW MEDICAL WORLD. 

The clothing worn by an itch patient should be destroyed or else 
disinfected by heat to destroy the itch-mite, also the under linen and 
bed clothes should be treated in the same manner. 

XVII.— RINGWORM OR TINEA. 

There are three diseases usually described as due to ringworm, 
depending upon the location of the affection. Ringworm of the 
scalj) is known as tinea tonsurans ; ringworm of the beard is other- 
wise called tinea sycosis or barber's itch, and ringworm of the body 
is known as tinea circinata. These affections are due to a vegetable 
parasite which multiplies within the tissues of the human body. 

Tinia sycosis or barber's itch is an affection of the hair follicles of 
the beard and face, not only the hair follicles becoming inflamed but 
also the surrounding tissues. It begins in small red spots, accom- 
panied by burning and itching. It is contagious and may be com- 
municated by the lather brush of the barber if the brush has been 
used upon the face of some person suffering from barber's itch. 

The hair becomes dull and dry and is easily pulled out or broken 
off. This disease does not get well without treatment. 

TREATMENT. 

The infected hairs may be removed and the following ointment 
applied night and morning: 

r> Oil cade one dram 

Ungt. hydrarg nitrate two drams 

Dngt. aqua rose one ounce 

.Mi\, and apply two or three times a day. 

In ringworm of the beard the inflammatory action is much more 
marked than in ringworm of the body, owing to the tendency to the 
formation of pus and the escape of fluid from the hair follicles, which 
dries and forms crusts. When crusts form they should be removed 
by first saturating them with sweet oil and then washing with ^<>ap 
and hot water. Then apply the ointment above as directed. 

Tinea tonsurans or ringworm of the scalp also requires thorough 

treatment. The hail" should be cut short and the head thoroughly 
washed with a lotion of carbolic acid, one dram to a pint of water. 



THE NEW MEDICAL WORLD. 22") 

After thorough cleansing the diseased hairs should be removed ; this 
treatment should be continued daily, followed by the application of 
some suitable ointment, as the following : 

Ijt Ungt. hydrarg nitrate one dram 

Beta naphthol one dram 

Vaseline one ounce 

Mix, and apply, externally three times a day. 

Ringworm may be contracted from several of the domestic ani- 
mals, when afflicted with the mange, as the horse, cow and cat. 

The treatment for these affections should not be discontinued until 
certainty of cure is established. 

XVIII.— FAVUS. 

This is a contagious disease, caused by a vegetable parasite derived 
from the\cat and other animals. It is characterized by dirty looking, 
cup-shaped patches or crusts, of a yellowish color, and emitting a 
peculiar musty or mousy odor. 

It usually occurs in the scalp and involves the health of the hair. 
It is not common in this country. The cause of this disease being 
known, such remedies must be used as will destroy or remove the 
parasite, when the diseased parts will be speedily restored. 

Mercurial ointments or lotions are generally used to accomplish 
this end, and ointments containing sulphur and tar are successfully 
used. 

This affection is so rare that the details of treatment are not con- 
sidered essential. Cleanliness is preventive of this as well as of 
many other disagreeable affections of the skin. 

XIX.— FRECKLES OR LENTIGO. 

Freckles are usually a slight disfiguration of the skin. They are 
especially likely to occur on persons who have light hair and com- 
plexion. 

Freckles are little circular spots, of small size, on the face and back 
of the hands. They are due to some disturbance in the even deposit 
of pigment. All skin is colored by pigment, which causes the hue 
known as flesh color. This color is considerably removed from 
white. Dark skinned persons have a more liberal deposit of pigment 



228 THE NEW MEDICAL WORLD. 

in the skin than iight persons. The color of the hair and eyes are 
due to special deposits of pigment. Pigment is excessively abundant 
in the skin of the negro race. 

Freckles are influenced by the sun's rays and are more noticeable 
in summer than in winter, and in cold weather they tend to disappear 
altogether. Freckles are very annoying to young ladies, if we may 
judge from the frequent demand from ladies' journals of recipes for 
their removal. The following lotion is harmless and useful : 

IJ, Carbonate of potash three drams 

Common salt two drams 

Rose water eight ounces 

Orange flower water two ounces 

Mix, and apply externally two or three times a day. 

i 
Also the following : 

$ Corrosive sublimate eight grains 

Zinc sulphate thirty grains 

Lead acetate thirty grains 

Water four ounces 

Mix. Apply for five or ten minutes thrice daily. (See Cosmetics.) 

XX.— MOLES. 

Moles are dark spots of discolored skin, which vary considerably 
in size. They are quite common, as but few persons escape the 
existence of one or more upon the surface of the body. 

Their color is due to an excessive deposit of pigment, and they are 
often the site of an unnatural growth of hair. They derive impor- 
tance when situated upon the face, in consequence of its disfigurement. 
Their removal is easily accomplished. 

When a mole shows a tendency to enlarge or to become unnatural 
its removal should be contemplated. Soft cancers of the melanotic 
variety have been known to develop upon the site of a mole, and 
hence any change in the appearance of a mole should be regarded 
with apprehension. 

The melanotic cancer when once established multiplies rapidly, 
spreading and becoming virulent. A mole may be removed by a 
caustic plaster, the same as an epithelial cancel- or by the knife. 



THE NEW MEDICAL WORLD. 229 

XXI.— WARTS OR VERRUCA. 

Warts result from an abnormal growth in the skin or a hyper- 
trophy, due to unknown causes. They are sometimes very numerous 
upon the hands. There are several varieties ; they vary in size, and 
there are certain persons and families which appear to be especially 
subject to their development. From general familiarity with these 
Growths further description is deemed unnecessary. 

TREATMENT. 

It is to be observed that they often disappear without any treat- 
ment. Sometimes they may be removed by tying a silk cord aboiu 
the base or pedicle and cutting off the sources of nutrition. This 
method answers well in those cases where the pedicle is small, but 
when the base of the wart is extensive other means must be used. 

The usual method is to pare off the upper surface of the wart with 
a sharp knife down to the bleeding point. Then apply some oil or 
vaseline about the circumference of the base to prevent injury to the 
healthy tissues. With a pine stick which has been dipped in strong, 
fuming nitric acid rub over the wart thoroughly. Its caustic effect 
will turn the touched surface yellow. After a few days pare off the 
destroyed surface and repeat the operation precisely as before if the 
wart does not appear to be destroyed thoroughly. Several applica- 
tions may be necessary, though two or three usually suffice. 

Instead of nitric acid, caustic potash may be used. This burns 
more deeply and one application, if properly applied, will be sufficient. 
Nitrate of silver can be used, but its caustic action is so mild that too 
many repetitions might be required. Chromic acid is an efficient 
caustic, and one application would be sufficient. 

Warts that tend to rapid enlargement and have a suspicious appear- 
ance should be removed, especially upon the face, lips and some other 
portions of the body, as epithelial cancers have sometimes had their 
origin in such warts. 

XXII.— CORNS OR CLAVITS. 

Nearly everyone is familiar with what are known as corns, and 
many have had actual experience. They are due to a thickening or 
hypertrophy of the skin, which becomes hard, almost like a piece of 
bone. They are usually about the size of a small split pea, but they 
vary considerably both as to size and form. 



230 THE NEW MEDICAL MOULD. 

Corns are of two kinds, hard and soft, depending upon their situa- 
tion. Between the toes soft corns are developed, and these are sub- 
ject to inflammation. They may cause but slight disturbance, or the}' 
may become so inflamed as to be not only sensitive and painful, but 
also interfere with ease in walking, and give one a limping gait. 
They sometimes occur upon the soles of the feet, -though not as com- 
monly as upon the toes and sides of the foot. 

CAUSE. 

They are caused by hard pressure and the friction of the boot or 
shoe ; hence they are often much more troublesome in warm than in 
cold weather. A loose or badly fitting shoe will cause corns as well 
as those which pinch and squeeze the feet. 

TREATMENT. 

Prevention here, as in thousands of other case's, is more satisfactory 
than cure. Wear well-fitting shoes, made of soft, pliable material, 
neither too loose nor too tight. The heel should not be too small 
nor too high. The fashionable French heel which brings the weight 
of the body upon the hollow of the foot is an abomination. 

The feet require especial care, yet no part of the body is so 
neglected or abused, or suffers more from vanity or silly fashions. 

The feet need frequent, and, if possible, daily bathing; and the 
nails should be carefully and closely cut and the dead skin removed. 
Such careful treatment prevents corns and other callosities. 

When coins exist soften them by soaking in hot water, pare oft the 
thickened skin down to where it is soft and pliable, but do not draw 
blood. Then apply the tincture of iodine every night and morning, 
forgetting not the importance of the daily bath. Make the same 
application to soft corns. A ring of felt with an opening in the center 
may be worn to lessen pressure and friction. Such a method of 
treatment will prove satisfactory and afford relief. The following 
treatment may be used instead if for any reason preferred: 

After soaking and paring the corns as directed above, paint them 
Over each night and morning with the following mixture: 

I> Salicylic acid thirty grains 

Ext. Indian hemp ten grains 

Collodion one and one-half ounce- 

In a few day- the hardened mass of epidermis can be easily 
removed after Making the feet in warm water. 



THE NEW MEDICAL WOKLD. 231 

The only medicine which has any effect upon the removal of corns 
when taken internally is arsenic, but the more natural and simple 
methods here recommended should certainly be preferred. 

XXIII.— BUNIONS. 

These are common and well known enlargements of the joint of 
the great toe. 

CAUSES. 

They are usually caused by shoes which taper too much and which 
press the end of the toe inward, leaving the joint so prominent as to 
be irritated by friction and pressure. Various occupations may have 
some relation to the production of these deformities, especially those 
which require constant standing and thus bring the weight of the 
body continually upon the feet. Sometimes they become very pain- 
ful, or very much inflamed, and troublesome sores may be formed 
which discharge pus and manifest considerable obstinacy in healing. 

TREATMENT. 

Preventive treatment in the way of properly fitting shoes is first 
and best of all. Tight fitting shoes with narrow toes should not be 
tolerated. Painting the enlarged joints with iodine is in the line of 
preventive treatment, and will do much good without doing harm. 
Cup-shaped plasters may be placed over the enlarged joints with 
good results and will give relief by relieving the pressure upon the 
enlarged bursa. The biniodide of mercury, two grains to an ounce 
of water, may be applied externally, and this treatment is recom- 
mended by high authority. 

Many other applications have been suggested, and even surgical 
operations for the relief of bunions, but they are too complex or 
difficult to introduce with any profit here. When the measures 
above proposed do not afford relief, and easy fitting shoes and res' 
do not avail, the case should be submitted to some one who is skillful 
in their treatment. 

XXIV.— SCURVY. 

Scurvy is a condition of the body due to the prolonged employ- 
ment of foods deficient in acids and vegetable matter. It breaks out 
as the result of a diet consisting exclusively of salt meats, smoked 
and dried fish or flesh; hence in famine stricken regions, among 



232 THE NEW MEDICAL WORLD. 

those shut in by siege, and on board of ships in long voyages, this 
disease in the past has often been of serious import. Since the mod- 
ern method of preserving fruits and vegetables by canning, it has 
almost become unknown. 

SYMPTOMS. 

These may be briefly stated as dull complexion, headache, dizzi- 
ness, loss of strength and vigor, or muscular debility, despondency, 
short breath, and finally effusion of blood into the skin, causing 
blotches, spots, ulcers and spongy gums which bleed easily. At 
length the prostration is extreme, the heart is slow and feeble, the 
mental powers are impaired, the face looks haggard, the sleep is 
broken, the glands become enlarged and swollen, and the hair falls 
off. Pains, mistaken for rheumatism, are felt in the limbs, joints and 
loins, and hemorrhage from the nose is common. 

The victim at length sinks into a condition of apathy. The blotches 
on the skin give name to the disorder. They are from the size of the 
finger nail to two or three inches in diameter. These spots are at 
first reddish, but later become darker colored or bluish. 

TREATMENT. 

Medicines are of little avail in this disease, for fruits and succulent 
vegetables are what the system craves. Lime juice has great reputa- 
tion. 

Those suffering from this disease, unless beyond the reach of help, 
recover rapidly on a change of diet. Onions, garlic, mustard, 
sorrel, dandelion, potatoes, beets, radishes, together with vari- 
ous fruits and lemons are among the best means of warding off and 
curing the scurvy. 

It is often observed how greedy city children are especially for 
green apples, pickles and unripe fruits, and how seldom they are 
injured by eating them. They are simply satisfying the system with 
what it craves. 



CHAPTER XII 

THE BRAIN, CRANIAL NERVES, SPINAL 

CORD, NERVES, SYMPATHETIC 

NERVES, AND THEIR 

DISEASES. 



I. — The Brain and Cranial Nerves. II. — The Nerves and 
Spinal Cord. III. — Hydrocephalus or Dropsy of the 
Brain. IV. — Meningitis or Inflammation of the Brain. 
V. — Neuralgia. VI. — Headache. VII. — Vertigo or 
Dizziness. VIII. — Insomnia. IX. — Insanity. X. — Apo- 
plexy. XL — Various Other Disorders of the Brain. 
1, Abscess of the Brain ; 2, Tumors of the Brain ; 3, 
Aphasia; 4, Amnesia; 5, Numbness; 6, Hemiplegia; 7, 
Paraplegia ; 8, Locomotor Ataxia ; 9, Facial Paralysis ; 
10, Congenital Defects, 

L— THE BRAIN AND CRANIAL NERVES. 

" What a piece of work is man ! 
How noble in reason ! 
How infinite in faculty ! " 

THE brain is a large and important organ consisting of an aggre- 
gation of nerve centers, together with the vessels by which they 
are nourished, and the coverings by which they are held in position. 

Coverings or Membranes. — The brain has three external cover- 
ings, the dura mater, the arachnoid and the pia mater. 

The Dura Mater. — The inside of the skull is covered over with a 
dense white membrane composed of fibers, called the dura mater. It 
is the periosteum of the skull, and surrounds the brain with a smooth 
covering, and its fibers hold the brain in position. The dura mater 
not only covers the interior of the skull, but it extends into the 
numerous openings of the bones and forms a lining so that the 
numerous nerves and blood vessels which pass through the openings 



234 THE NEW MEDICAL WOULD. 

in the bones are surrounded by a smooth surface. The dura mater 
is attached to the sutures and its reflections form the sinuses which 
receive and transport the venous blood. 

It holds the lobes of the brain in place, and prevents them from 
pressing upon each other in the different positions assumed by the 
body. 

The Arachnoid. — Next to the dura mater is the arachnoid mem- 
brane, a thin, delicate tissue, which secretes a fluid known as the 
cerebro spinal or arachnoid fluid. When the base of the skull is frac- 
tured the arachnoid fluid is liable to escape slowly through the ear. 
This fluid helps to maintain the positions of the various portions of 
the brain ; it equalizes the pressure and so prevents injury from con- 
cussion. 

The Pia Mater. — The pia mater is a thin tissue which forms the 
outside covering of the brain substance. It contains a large number 
of blood vessels which transport the arterial blood for nourishment 
and gather up the venous blood and empty it into the great sinuses. 
It dips down into the deep fissures of the brain and forms a covering 
for all the lobes. 

The brain, though contained within the skull, is connected by 
means of the spinal cord and its branches with every other organ 
and tissue of the body. 

The main divisions of the brain are the cerebrum, the cerebellum, 
the pons Varolii and the medulla oblongata. 

The brain substance which fills the entire cavity of the skull and 
conforms to its shape is quite soft, of a white and gray color, known 
as the white and gray matter, the latter being external and gathered 
into numerous convolutions which add greatly to its extent, and 
several deep fissures increase its surface. The gray matter is the 
scat of the intellectual faculties, and the character of the intellect 
depends less upon the size of the brain than upon the amount of the 
gray matter. The average weight of the male brain is forty-nine 
ounces, and that of the female forty-four ounces. The brain con- 
tains the great nerve centers which recognize sensation and originate 
motion. It contains also the nerve centers of the special senses. 

The Cerebrum. — Four-fifths of the space within the skull is occu- 
pied by the cerebrum. It extends from the forehead to the occiput 
and overlies all the other portions of the brain, occupying the whole 
upper pari of the cavity of the skull. A large fissure running from 



THE NEW MEDICAL WORLD. 235 

before backwards divides the cerebrum into two nearly equal halves 
or hemispheres. It is further divided by deep fissures which sepa- 
rate each hemisphere into three lobes known as the anterior, middle 
and posterior lobes of the brain. The cerebrum is separated from 
the cerebellum by folds of the dura mater called the tentorium. The 
two hemispheres are united at the bottom by a band of white trans- 
verse fibers known as the commissure, or the corpus callosum. 

The Cerebellum. — The cerebellum is situated in the occipital 
chamber of the skull, and is also divided into two hemispheres, joined 
together in the central portion. The cerebellum controls the co- 
ordination of muscular, movements. It is connected with the medulla 
oblongata by means of fibers. 

The Pons Varolii — The pons Varolii is the name given to the 
upper and bulbous portion of the medulla oblongata. It is composed 
of white fibers which connect the medulla to the cerebellum and the 
gray matter which is deposited among them. 

The Medulla Oblongata. — The medulla oblongata is the expanded 
and upper end of the spinal cord. It conveys impressions to and 
from the brain. The nerve fibers in the medulla cross each other 
from side to side so that an injury to one hemisphere of the brain is 
followed by paralysis in the opposite side of the body. 

The brain is very liberally supplied with arterial blood, which 
enables it to prosecute with energy its manifold labors. The arteries 
of the brain pursue a tortuous course so that the impulse given to the 
blood by the powerful stroke of the heart is not felt as a disturbing- 
force. The arrangement which is made in the great venous sinuses 
for receiving and disposing of the venous blood, prevents too great 
blood pressure upon the brain, which would prove injurious in many 
ways. 

A more complete description of the brain would involve such a 
large number of technical terms as to weary the patience of the gen- 
eral reader and is omitted. 

The Cranial Nerves. — (For origin see plate.) — Twelve pairs of 
nerves have their origin in the base of the brain near the fourth 
ventricle. 

The first pair, the olfactory, give off about twenty branches on 
each side which are distributed to the mucous membrane or lining of 
the nose. These are the nerves by which we take cognizance of 



230 THE NEW MEDICAL WORLD. 

different odors and they convey the impressions of odor to the brain. 
The olfactory bulbs lie in front of the optic commissure. 

The second pair, the optic nerves, pass from the optic commissure 
to the back part of the eyeballs and are spread out upon the retina. 
These are the nerves of sight and convey the impressions of objects 
to the brain. 

The third pair, or the motor oculi, are the nerves which control 
the movements of the muscles of the eye as their name implies. 
They originate in front of the pons Varolii and extend to the mus- 
cles of the eyeball. 

The fourth pair extend to the muscles of the eyeball. They arise 
near the origin of the third pair and extend to the superior oblique 
muscles of the eye which are not reached by the third pair. The 
fourth pair are also known as the patheticus or trochlear nerves. 
They act in harmony with the third pair. 

The fifth pair, trigeminous or trifacial, arise from the vicinity of 
the pons Varolii. They are the largest of the cranial nerves and are 
widely distributed to the regions of the face. They are all mixed 
nerves, possessing functions of motion and sensation. They become 
three great divisions, the opthalmic which extends to the region about 
the eyes, forehead and nose ; the superior maxillary, which is dis- 
tributed to the upper teeth and a wide region of the face ; the inferior 
maxillary, which is distributed to the lower teeth and the region about 
the lower jaw. This nerve is often the seat of much pain known 
as headache, toothache and neuralgia of the face or tic douloureux. 

The sixth pair supply the external recti muscles of the eye. 

The seventh pair or facial are distributed to the muscles of the 
face. They are motor nerves exclusively. 

The eighth pair of cranial nerves, the auditory, are closely asso- 
ciated with the facial and were formerly regarded as a part of the 
seventh pair. They are distributed to the external ear. 

The ninth pair are distributed to the pharynx and the back part of 
the tongue. 

The tenth pair, the pneumogastric, is widely distributed reaching 
the pharynx, larynx, heart, lungs, (esophagus and stomach. From 
its wandering course it is often called the vagus nerve. 

The eleventh pair receive their name, the spinal accessory, from 
their singular origin ami course. 

The twelfth pair of cranial nerves is distributed to the muscles of 
the tongue. The nerves of special sense not only originate in the 




The base of the brain, showing the Cerebrum, Cerebellum, Pons Varolii, Medulla and the 
origin of nine pairs of the Cranial Nerves. 

1, olfactory; 2, optic ; 3, motor oculi ; 4, patheticus ; 5, trifacial; 6, oculi abducens ; 7. 
facial ; 8, auditory ; 9, glossopharyngeal. 




The cranial nerves on tbe left side. 



238 THE NEW MEDICAL WOBLD. 

brain but also terminate in a neighboring portion of the head except 
the nerves of touch, which pass to every portion of the external sur- 
face of the body. 

II.— THE NERVES AND SPINAL CORD. 

The nerves form a network of the entire body. They convey im- 
pressions to the brain and control movements in conformity to the 
will. This subject is one of unusual interest. There are two kinds 
of nerve structure, the gray, in which impressions originate and the 
white, which transmits the impression. 

The nerve substance originates and conveys impressions to control 
the action of the various organs. There are two systems ; viz : the 
cerebro-spinal and the sympathetic. The cerebro-spinal system is 
made up of the brain, the spinal cord and their branches. The cere- 
bro-spinal system presides over the functions of animal life and the 
intellectual processes. 

The sympathetic system presides chiefly over the work of nutri- 
tion and growth. It is indirectly connected with the brain and 
spinal cord and their functions are not so absolutely separate as was 
once supposed. The sympathetic system is known to be connected 
with the cerebro-spinal system by means of interlacing branches 
which are the channels of communication. The sympathetic system 
consists of a series of ganglia on either side and in front of the spinal 
column connected together by means of nerve fibers. 

The Spinal Cord. — This is the great line of communication be- 
tween the brain and other portions of the body. It occupies the 
canal formed by the vertebra? and is surrounded by fluid to prevent 
its injury. On its passage from the brain it gives off branches on 
each side forming thirty pairs of nerves. 

The branches which go to the upper and lower extremities are 
necessarily large. The spinal cord in structure resembles the brain. 
The internal portion of the cord contains the gray substance which 
is surrounded by white fibers that pass in longitudinal, transverse and 
oblique directions. These membranes envelop the cord; the outer is 
the dura mater, the middle the arachnoid, and the inner the pia 
mater, a continuation of the enveloping membranes of the brain. 
The front portion of the cord transmits impressions from the brain to 
the muscles. 



THE NEW MEDICAL WORLD. 



239 



The gray substance carries sensations from without to the brain. 
The back portion of the cord controls the co-ordination of muscular 
movements. The spinal cord also produces reflex or unconscious 




Showing network of nerves in the body. 



Spinal Cord. 
Showing also on the 
left side the sympa- 
thetic ganglionic 
masses. 



movements. Reflex movements are such as are produced independ- 
ent of the will. The acts 'which we do in sleep are reflex. 

As a branch passes out from the cord it contains fibers from the 
anterior and posterior columns of the spinal cord, so that these spinal 



240 THE NEW MEDICAL WORLD. 

branches are mixed nerves, or nerves of motion and sensation ; and 
however much these nerves are divided and subdivided they are 
always mixed, containing the two sets of motor and sensitive fibers. 
The nerve force is peculiar. It passes as rapidly along a nerve as 
electricity does a wire. It is owing to the action of the nerve force 
that muscular movements are skillfully performed. 

III.— HYDROCEPHALUS, OR DROPSY OF THE BRAIN. 

This is a disease characterized by an excessive amount of fluid in 
the spaces and tissues of the brain. It is in many cases a congenital 
affection and exists at birth. 

The first thing noticed is the excessive size of the child's head, it 
being out of proportion to the rest of the body. Children born with 
hydrocephalus usually die within a year but a few cases of recovery 
have been reported. 

CAUSES. 

When this disease comes on after birth the exciting causes to be 
considered are fevers, falls, blows upon the head, tumors of the 
brain, diseases of the heart and lungs, Bright's disease of the kid- 
neys, unfavorable surroundings and disturbances of the nervous sys- 
tem. 

SYMPTOMS. 

In congenital cases the digestion is poor and much disturbed, the 
face has an old, wrinkled look, the intellect is impaired, standing upon 
the feet or walking is delayed and the weight of the head seems too 
great for the strength of the body. 

When the disease comes on suddenly the symptoms at first are 
headache, intolerance of noise and light, delirium, restlessness fol- 
lowed by stupor and coma. Or the disease may approach with nau- 
sea, vomiting, fever, twitchings and finally convulsions. The pupils 
of the eyes may be of unequal size, the pulse irregular and the 
bowels constipated. The symptoms increase in seventy till a state 
of complete stupor is reached and recovery cannot be predicted. 

TREATMENT. 

Only mild cases, when the symptoms are arrested previous to con- 
vulsions, recover. Congenital eases need pure air, nutritious food, 
suitable tonics and aids to digestion. Acute cast's are t<» be treated 
as the symptoms require with brain sedatives, antispasmodics and 
perhaps stimulants. 



THE NEW MEDICAL WORLD. 241 

IV.— MENINGITIS OR INFLAMMATION OF THE BRAIN. 

This disease was formerly known as brain fever. There are sev- 
eral varieties. Simple meningitis is an inflammation of the pia mater, 
or outer covering of the brain. 

Tubercular meningitis is another and more serious form of inflam- 
mation of the brain. Its beginnings are insidious, its progress 
chronic, and its termination usually fatal. The diagnosis of the sec- 
ond form during life is uncertain and difficult, for the symptoms are 
often mistaken for malarial fever or worms. This form of meningitis 
is more likely to occur where there is a marked history of tubercular 
consumption in the family. Tubercular disease attacks not only the 
lungs, but sometimes the brain and bowels. 

Cerebro-spinal meningitis is an acute inflammation of the brain of 
intense character. It involves the base of the brain and extends 
into the spinal cord, and hence its name. It attacks young persons, 
especially between the ages of fourteen and twenty-five. It occurs 
sometimes as an epidemic, and on account of the peculiar character 
of the fever which accompanies it, it was formerly called spotted 
fever. 

CAUSES. 

The causes of inflammation of the brain are quite varied, as blows 
upon the head and falls of so serious a nature as to injure the tissues 
of the brain. It is sometimes the result of prolonged exposure to the 
excessive heat of the sun's rays, and begins as a congestion, followed 
by fever and other symptoms. 

The excessive use of alcoholic stimulants causes a condition of 
congestion, and if long continued may result in meningitis. 

In childhood it often follows and terminates in other serious diseases, 
as cholera infantum, scarlet fever, or pneumonia; also other acute 
affections of the adult, as erysipelas, rheumatism, B right's disease, 
and typhoid fever. It may also result from chronic disease of the 
ear, and in such cases the destruction of tissue due to the continued 
flow of pus at length reaches the brain and sets up inflammation. 

SYMPTOMS. 

The more common symptoms are severe headache, vomiting, rest- 
lessness or stupor, delirium and convulsions. The face is pale, the 
features are sunken, the pupils of the eyes may be dilated or con- 
tracted, the urine is scanty, and the bowels constipated. The pain 



242 THE NEW MEDICAL WOULD. 

in the head is often acute, causing the patient to cry out or scream 
when a change of position is attempted. Light and noise increase 
the suffering. There is. great restlessness, often inability to sleep, 
the skin is hot and dry, twitchings and convulsions are prominent, 
and in fatal cases coma precedes death. 

In tubercular meningitis the early symptoms approach gradually, 
the patient is languid and feverish ; vomiting may occur, and for this 
disturbance no cause appears. The patient loses flesh and strength, 
grows pale, and seems disinclined to make exertion of any kind. 
The sleep is disturbed, the child often starting or moaning, grinding 
the teeth and rolling the head from side to side. The thermometer 
shows a continued rise of temperature. In brain troubles the respira- 
tion is slow, the pulse is slow and intermittent when the temperature 
is high ; this is an important symptom. 

TREATMENT. 

A disease so grave demands professional skill and no line of treat- 
ment could be safely followed by the household. Meningitis is al- 
ways serious and often fatal and requires careful attention. In the 
acute forms with much fever cold applications to the head are indi- 
cated, either cold water or ice. The bowels should be kept open by 
gentle physic. Tincture of aconite is a valuable remedy to relieve 
congestion of the brain. To produce rest chloral is preferable to 
opium. Bromide of potash and other brain sedatives are beneficial. 

Gelsemium and ergot are remedies which in skillful hands may be 
successfully used. The diet should be nourishing and consist of milk, 
beef tea and other liquid food. If stimulants are indicated the aro- 
matic spirits of ammonia in teaspoonful doses well diluted for 
an adult or brandy may be used. The patient ought not to be dis- 
turbed by noise and excitements. The nurse should move about 
carefully and exclude most of the light from the room. Medicines 
given in the early stages may avert the fatal consequences of this 
disease. Preventive remedies such as proper diet, ventilation and 
keeping delicate children away from school until a suitable age will 
do much toward building up the constitution where there is danger 
to be feared from the development of tubercular disease. 

V— NEURALGIA. 

Neuralgia is pain of a nerve, often due to an overtaxed or im- 
poverished condition of the nervous system. It is in such cases the 



THE NEW MEDICAL WORLD. 243 

cry of a hungry nerve for nourishment. Neuralgia is an exceedingly 
common affection. It exists apart from fever and inflammation, and 
without any apparent cause. Pain is the most prominent and often 
the only symptom present. The pain is sharp and cutting, of a 
movable character, often obstinate and more severe at some times 
than others. While the skin may be sensitive to the touch, firm 
pressure usually relieves the pain, and distinguishes neuralgia from 
any ordinary inflammation. Motion of the affected parts increases 
the pain. 

Some persons are much more subject to neuralgia than others, 
especially those of a nervous temperament, as frail women, and those 
who inherit a tendency to nervous troubles. 

The duration of an attack of neuralgia is indefinite. It may last 
only a few hours, or it may continue for days and weeks and the 
termination is often gradual. There are many different varieties of 
neuralgia, and the locality of the affection furnishes the particular 
name which designates it. 

Neuralgia of the head is called migraine, and is usually confined to 
one side of the head. Other names which may be applied are nervous 
headache, hemicrania, and neuralgic headache. 

Neuralgia of the face is called tic-douloureux. The pain is usually 
very severe, and is increased by exposure to cold air, wind and 
dampness. 

Neuralgia of the chest is called intercostal ; that about the heart, 
angina pectoris ; that of the stomach, gastralgia ; of the back and 
loins, lumbago ; of the ovaries, ovarian ; of the thighs, sciatica ; and 
that of the skin accompanied by eruptions, herpes zoster or shingles. 
These form a class of common affections frequent in occurrence and 
often troublesome. 

CAUSES. 

Among the predisposing causes are heredity and certain periods of 
life. Women are much more frequently the victims of neuralgic 
pain than men as might be expected from their liability to uterine 
diseases. Certain other diseases as rheumatism, gout, anaemia, s} r ph- 
ilis and malaria have much to do with the development of neuralgic 
troubles. Among exciting causes the following are sufficiently prom- 
inent to mention : atmospheric changes as heat, cold and dampness, 
bad teeth, broken bones, the pressure of tumors and other growths, 
injuries, irritation or pressure upon a nerve, the poison of any miasm 



•J44 THE Xi:\V MKDKAL WORLD. 

acting upon the nervous system, the presence of worms, in fact what- 
ever overtaxes or impoverishes the nervous system. 

It is especially noticeable that neuralgia is common in cold and 
damp weather, in damp locations or as the result of exposure to 
storms. 

TREATMENT. 

• 

The successful treatment will depend much upon the cause and 
hence no special line can be proposed. Local causes of irritation 
should be remedied and removed. Decayed teeth, errors in refrac- 
tion and uterine troubles ought to receive appropriate attention. 

When dependent upon anaemia, malaria, rheumatism, gout or syph- 
ilis these diseases must receive attention adapted to each case. In 
the great majority of cases some fault of nutrition exists and for 
these cases nerve tonics such as phosphates are excellent. Over- 
work and excessive nerve strain should be avoided and their past 
effects corrected. Change of climate, rest from wearying occupa- 
tions and an improved diet will help many cases. Indigestible foods, 
hot bread, pastry and cakes aggravate digestive troubles and should 
be avoided. The habits if bad should be corrected as late hours, late 
suppers or the use of tobacco and alcohol. 

A proper amount of sleep should be secured. Baths, if possible 
salt water baths, and friction of the skin with a rough towel or flesh 
brush are especially seaviceable for those who experience incon- 
venience from atmospheric changes. Suitable clothing, preferably 
woolen, should be worn next the skin at all seasons. In summer it 
may be of very light weight. 

Electricity may sometimes be used to advantage. Local applica- 
tions of heat and of stimulating liniments may afford considerable 
temporary relief ; counter irritants, as mustard, turpentine, or perhaps 
chloroform stand highest in the list of local remedies. Menthol lini- 
ment will often relieve headache and neuralgia of the face. The 
following mixture makes a liniment of considerable efficiency : 

$, Oil of mustard one dram 

Camphor liniment three and a half oun< 

Chloroform four drams 

Mix, and apply on a piece of flannel or muslin. 

The most efficient internal remedies are the phosphate of iron. 



THE NEW MEDICAL WORLD. 245 

quinine, arsenic and strychnine, combined in a pill or tablet form. 
(See Anaemia.) 

VI.— HEADACHE. 

Headache claims many sufferers ; it is not only of frequent occur- 
rence, but of great variety. The brain is a delicate and complex 
structure. It is no wonder that in the severe struggle of modern life 
this great group of nerve centers is liable to suffer from such opposite 
conditions as congestion and exhaustion or anaemia. The nervous 
system is liable to be overtaxed by the frequent demands made upon 
it without sufficient opportunity for rest and recuperation. 

The brain is subject to constant burden and overwork. There 
can be no thought and no emotion which does not reach and often 
thrill it. There can be no anxious care which does not add to its 
burden. Every part of the human body communicates directly with 
the brain, and hence our various ills all tend to depress and exhaust 
it. Any functional or organic disease of the various organs is likely 
to act as a debilitating force upon the brain. 

CAUSES. 

Digestive troubles and all affections of the stomach, liver, womb, 
or ovaries are frequent causes of headache. Defective vision, causing 
eye strain, or malarial poison circulating through the system produce 
headache of a persistent type. Any excessive indulgence at the 
table, the use of alcoholic drinks, or narcotic medicines are liable to 
cause headaches. 

Gratification of the sensual passions tends to consume the vital 
forces and debilitates the nervous system, and may be a frequent 
cause of this affection. The two most prominent factors in head- 
aches appear to be excitement, causing congestion of the brain, and 
exhaustion, causing anaemia. Thus we have two opposite conditions 
producing the same symptoms. 

In congestive headache the blood vessels of the brain are dilated 
and distended, the face is often flushed, the eyes red or bloodshot 
and the arteries full and throbbing. Congestive headache may be 
due to an enlarged heart or to its excessive action so that the tissues 
of the brain receive too much blood. Or there may be some obstruc- 
tion which prevents the rapid return of the venous blood. Excessive 
or prolonged mental work may attract sufficient blood to the brain 



246 THE NEW MEDICAL WORLD. 

to cause congestion and a resulting headache. In fevers the head- 
ache is of the congestive variety. The heat of the sun sometimes 
causes an intense congestive headache. 

Anremia causes a headache due to an impoverished and watery 
condition of the blood, and the brain surfers for want of nourish- 
ment. The sufferer from this form of headache is 1 weak, faints easily, 
has cold feet and poor circulation. There is a marked lack of vital- 
ity, inability to sleep, irritability and nervousness. This is the head- 
ache of exhaustion and nervous prostration, and is very similar to 
neuralgia, the hungry nerves uttering their constant protest against 
starvation. 

Headache may result from many other causes, as poorly ventilated 
rooms, the inhalation of carbonic acid gas from burning charcoal, 
overstudy, colds, catarrh, gout, rheumatism, fevers, syphilis, or what- 
ever affects, either temporarily or permanently, the delicate tissues of 
the brain. The duration of a headache may be a few minutes or 
several days, or even months. 

TREATMENT. 

Much skill is often required in managing this affection which at 
first appears so innocent. If the cause is known the treatment is 
usually simple. Cold applications to the head often relieve a conges- 
tive .headache. Wet a towel in equal parts of strong vinegar and 
water and tie about the head. It will help the result to soak the feet 
in hot mustard water. If constipation exists or biliousness is sus- 
pected open the bowels freely. Fifteen grains of the bromide 
of lithium or sodium, or a live grain tablet of acetanelid or a dessert 
spoonful of the effervescing hydrobromate of caffeine are all efficient 
remedies. 

For the headache of exhaustion and overwork nerve foods or 
tonics are indicated. In headache of this variety the phosphates are 
valuable. Tablets of the phosphate of iron, quinine and strychnia 
may be used. Rest, change of climate and a nourishing diet are often 
quite as curative as medicines. 

Headache is a symptom of many other diseases, as malaria, hysteriai 
constipation, uterine disturbances, fevers, and diseases of the kidneys. 
Menthol applied externally is beneficial in some forms of headache. 

For hysterica] headache use one teaspoonfa] of the ammoniated 
tincture <>t" valerian mixed with a wine glass of water. 



THE NEW MEDICAL WORLD. 247 

The following may be used for anaemic headache : 

5, Reduced iron ten grains 

Arsenious acid one-half grain 

Podopliyllin. one grain 

Ext. gentian twenty grains 

Mix, and make into twenty pills. Dose, one three times a day 
after meals. 

For nervous headache the following will afford temporary relief : 

r} Aromatic spts. of ammonia one ounce 

Spts. of chloroform one dram 

Water q.s. to make two ounces 

Mix. Dose, a teaspoonful in water. 

VII.— VERTIGO OR DIZZINESS. 

Vertigo is a symptom of various conditions rather than a disease 
in itself. It is caused by a disordered circulation of the brain, or a 
congestion of that organ. A sedentary occupation, with little exer- 
cise and a hearty, unrestrained appetite is liable to bring it on. A 
disordered condition of the digestive organs, especially the stomach 
and liver, are among the more prominent causes. The arrest of 
digestion, chronic dyspepsia, constipation, intellectual or physical 
fatigue, fevers, inflammation, blood poisoning, malaria, exhausting 
hemorrhages, derangement of the menstrual functions, exposure to 
the heat of the sun, or similar causes, may favor attacks of vertigo. 
The irritation resulting from disease of the ear, or from foreign 
bodies in the ear, or organic disease of the brain, may result in 
vertigo. Certain drugs, as alcohol, tobacco, belladonna and others, 
may act as causes. The most frequent cause, however, is disordered 
digestion. 

An attack of vertigo may be momentary, or it may last an indef- 
inite period. The degree and duration will be likely to depend upon 
the cause. Old people are more subject to attacks of vertigo than 
any other class. 

TREATMENT. 

When vertigo is associated with flushed countenance and distention 
of the veins and arteries of the temple it is suggestive of apoplexy, 
and should receive prompt attention. When vertigo is associated 



248 THE NEW MEDICAL WORLD. 

with the opposite condition, as pallor and anaemia, it is usually due 
to weakness, indigestion and disorder of the uterine functions, and 
requires a line of treatment to enrich the blood and improve the 
general condition. The treatment demands a diligent search for the 
cause. 

In all cases the diet should be regulated and the course of life made 
to conform to hygienic laws. If animal food has been used to ex- 
cess let a milk and vegetable diet be substituted. When due to over- 
work, rest and change of air, as a summer at the seaside or a trip 
across the ocean, will be found preferable to medicine. Constipation 
should be relieved, the use of tobacco regulated or abandoned. De- 
fective vision should receive attention. Diseases of the ear should be 
looked after and intelligently treated. When vertigo is caused by 
disease of the inner ear it is persistent and difficult to reach. When 
signs of cerebral congestion exist the following will be found effi- 
cient : 

5, Extract ergot, fl. one ounce 

Tr. digitalis two drams 

Bromide of potash one ounce 

Syr. orange peel two ounces 

Water to make eight ounces 

Mix. The dose of this is one dessertspoonful every four hours. 

If anaemia exist the remedies recommended for that affection or for 
headache due to anaemia are reliable. 

VIII.— INSOMNIA. 

Inability to sleep is often a serious trouble to the brain worker. 
It is impossible to continue mental or physical exertion without a 
proper amount of sleep and not incur the danger of nervous exhaus- 
tion. In fact it is a prominent symptom of brain exhaustion. 

CAUSES. 

It is often the symptom of some affection, or it may be due to tem- 
porary emotions. Its chief cause is congestion of the tissues of the 
brain, a condition which is invited by overwork, great anxiety, 
depressing emotion, or excessive activity of the tissues of the brain. 
The patient is often nervous, sometimes hysterical, lie-- awake a long 



THE NEW MEDICAL WORLD. 249 

time after retiring, all the activities of the day pass in review, the 
brain is active, thought succeeds thought, plan succeeds plan, the 
head is hot, the heart beats heavily, and the reclining position seems 
less favorable to sleep than the upright posture. Some people are 
awake very early in the morning, at two or three o'clock, and are 
unable to get to sleep again. Among the causes may be mentioned 
chronic heart disease. Pregnancy often causes insomnia. It may be 
the indication of approaching insanity. The insane are usually poor 
sleepers. 

TREATMENT. 

Leave off mental work some time before retiring and take a walk 
out of doors. The head may be bathed with cold water and cooling 
lotions. Country air is good. Take a vacation, or sea voyage, 
especially in a sailing vessel. Hot foot baths or sponge baths are 
beneficial ; avoid late suppers, and sleep in a cold room with the 
window open. Quiet the nervous system by good habits, regulate 
the daily life, attend to the digestion and relieve constipation. 

Avoid spirits, as they only lead from bad to worse. Bromide of 
potash may be used with less danger than opium, but it affords no 
nourishment to the exhausted brain. Sulfonal in powder of five 
grains may afford relief. Chloral may be used sometimes with benefit 
to calm the excited brain and produce much needed sleep, but it is 
not safe to resort to such a remedy except as it is recommended by 
the medical adviser. 

When sleeplessness is due to organic disease it must receive the 
attention of the doctor. The warm bath before retiring is an excel- 
lent remedy. The bath should be warm, 95 degrees or more, and 
continued from twenty minutes to half an hour. This may be 
followed, if necessary, with cold applications to the head. 

IX.— INSANITY. 

Insanity appears to be due to a disordered condition of some of 
the nerve centers of the brain, which is sufficient to produce derange- 
ment of the thoughts, feelings, or actions, or all combined. When 
the functions of the brain are so disordered as to render the patient 
incapable of fulfilling the ordinary relations of life, his condition is 
known as insanity. 



THE NEW MEDICAL WOULD. 

While it is difficult to <rive a satisfactory definition of the term 
insanity, yet, according to modern investigation and teaching, it is 
a condition resulting from a disturbance or disease in some portion 
of the brain. Yr -}>eeting the character of this disease have 

undergone no little change during the past twenty 

The history of insanity, if not as old as the race, run.> back to a 
very remote period. It is a well recognized and unpleasant fact that 
the number of insane per- us > steadily on the increase : yet it must 
be borne in mind in accepting this statement that the recognition of 
insanity has broadened very much, so as to embrace a large number 
not formerly included. The medical skill of today renders thi> dis- 

B more readily detected than formerly. It is not strange, too. that 
insanity increases when we consider the increasing demands of our 
exacting civilization, and the only cause for wonder Is tha* - 
brains are overwhelmed by the intensity and perplexity of modern 
life. 

CAUSES, 

These are both predisposing and exciting. Among the pre 
posing, the hereditary tendency to insanity stands tirst, and do* 
this stands the intermarriage of tho>e who are so closely related 
be unable to produce a vigorous and healthy progeny. Snch mar- 
riages result in deterioration of offspring although the rea- 
such degeneracy cannot be easily explained. Other predisposing 
l ire long continued ill health, which finally result> in a h 
•ondition of melancholy: an overcrowded population, rendering 
the struggle for life, on the part of the poorer classes, desperate and 
re. 

The exciting causes are intemperance, overwork, mental anxiety 
an«l worry, disappointment) especially in love, political or religious 
excitement, prolonged domestic or business troubles, poverty. ssec 
which overtax the strength and debilitate the body, an ially the 

brain. 

SYMPTOMS 

The symptoms of insanity are numerous and varied. They are 

usually classified under the three heads of illusion-, delusion and 

hallucination. The more noticeable and common symptoms are a 

change of characti increased irritability, a 

m of memory, and a loss of interest in affau - 



THE NEW MEDICAL WORLD. 251 

There may be a loss of self-control, a manifestation of stupor or 
violence, and usually a disposition to be suspicious, cunning, and in 
nearly all cases sleeplessness. The usual classification of the differ- 
ent forms of insanity is mania, melancholia and dementia, and under 
one or the other of these heads every form of insanity may be placed. 

TREATMENT. 

The treatment of insanity requires the control and restraint of the 
patient for his own protection and for the protection of others. These 
are especially prominent requirements in that form of insanity known 
as acute mania. Attention must be given to the bodily functions in 
order to secure their healthful action. The tendency to constipation 
and wakefulness so often characteristic of the insane should be 
remedied. Sufficient nourishment is essential, and it is sometimes 
necessary to resort to artificial methods of feeding in order to fulfill 
this requirement. The treatment for insane cases can only be out- 
lined in a general way, for each case needs to be studied and have a 
treatment especially appropriate for its own peculiarities. 

Some cases do better at home, surrounded by friends, where free- 
dom from restraint and care are secured ; other cases do better in an 
asylum, away from friends and under the influence and control of 
strangers. Much improvement has been made in the treatment of 
the insane in recent years. Quite as much dependence is now made 
upon such remedial agents as rest, nutritious diet, baths, fresh air 
and agreeable occupation, as upon medicines. 

When medicines are required they must be so chosen as to meet 
the individual requirements of the case in hand. Such medicines as 
improve the appetite and digestion are often needed. Medicines to 
relieve constipation, aid sleep and improve the general condition 
may be required. The sources of irritation should be ascertained 
and removed. Drugs to produce sleep should be chosen with care 
and used with good judgment. Rest and travel are often important 
aids to recovery. 

X.— APOPLEXY. 

Apoplexy is the result of pressure upon the brain due either to 
congestion or hemorrhage within the skull. If due to hemorrhage, 
there is the rupture of a blood vessel, and pressure upon the brain is 
caused bv a clot of blood. 



252 THE NEW MEDICAL WORLD. 

An attack of apoplexy is usually sudden, and for this reason it is 
sometimes called a stroke. It is unusual in children and young 
persons, but after sixty years of age it is quite a common cause of 
death. 

SYMPTOMS. 

Previous to an attack of apoplexy there may be some premonitory 
symptoms, as headache, vertigo, drowsiness, confusion of the mind, 
loss of memory for words, causing their wrong use, a changed 
disposition, weakening of one side of the body, and other similar 
warnings. In other cases the attack comes on suddenly, the patient 
falling insensible without warning. The facial muscles and tongue 
are drawn to one side, and the stupor is sudden, with snoring respira- 
tion. The pulse is slow, the face flushed, and the unconsciousness 
profound. Apoplexy is associated with more or less paralysis of a 
leg, arm, or of one side of the body. Partial or complete recovery 
may take place, but the mental force is ordinarily more or less per- 
manently impaired. 

CAUSES. 

The cause of this disease is a degenerate condition of the blood 
vessels of the brain, which permits their rupture when the force of 
extra exertion or pressure is brought to bear upon them. Predis- 
posing causes are high living, mental excitement, lymphatic tempera- 
ment, age, and the use of alcoholic stimulants. Whatever determines 
an unusual quantity of blood to the brain and retards its return may 
help to cause the rupture of a blood vessel and result in a stroke of 
apoplexy. 

TREATMENT. 

When apoplexy is threatened, but has not occurred, means should 
be taken to relieve the brain from excessive blood pressure. Medi- 
cines which relieve congestion by contracting the blood vessels are 
beneficial. Mustard draughts may be applied to the feet, and cold 
applications, as vinegar and water, or ice, to the head. Rest should 
l>c maintained in a cool room, the bowels opened freely, and the 
head well elevated; and (piiet is essential. Do not give solid food, 

hut milk ami beef tea arc appropriate. 

The aromatic spirit^ of ammonia, it* stimulants are needed, may be 



THE NEW MEDICAL WOULD. 253 

given in teaspoonful doses. When it is known that hemorrhage lias 
occurred it is usual to give a dose of physic. Aconite in one drop 
doses of the tincture every hour or two is beneficiaL 

After a few weeks, massage and electricity are appropriate to over- 
come the wasting of the paralyzed muscles and to aid in their restora- 
tion. Many other remedies could be suggested, but remedies are of 
little avail in this disease, unless adapted to the individual case in 
hand. A young and vigorous patient is more likely to recover than 
one who is aged and feeble. 

Bleeding was formerly much resorted to in the treatment of apo- 
plexv, but recent medical practice favors it only in rare cases and 
when the condition of plethora is well marked. In a few cases it 
may be advantageous. It is safe to administer medicines to act upon 
the bowels freely in every case. 

XI.— VARIOUS OTHER DISEASES OF THE BRAIN. 

Abscess of the Brain. — An inflammation sometimes takes place 
in the brain followed by a localized collection of pus. The cause 
may be stated as contusion and other injury, or caries of the cranial 
bones. The abscess may be as small as an almond or pea, or it may 
be much larger. The abscess is usually encysted or enclosed in a 
membrane. The symptoms are similar to those of brain disease in 
general, and the diagnosis cannot be made by ordinary individuals. 
These cases usually terminate fatally, but surgical interference has 
brought some recent cases to a successful issue. 

Tumors of the Brain. — These growths within the brain are rare 
and can be dismissed with few words. Tumors within the brain 
affect it unduly on account of pressure. Cancer within the skull 
terminates fatally. Tho diagnosis is uncertain and the treatment 
unpromising. The symptoms resemble meningitis, apoplexy, and 
pressure. See general articles on tumors. 

Aphasia. — This is inability to use language or express ideas. It is 
one of the common results of apoplexy. 

Amnesia. — Is loss of memory, either real or apparent, temporary 
or partial. A familiar word or fact sometimes escapes a speaker 
which, for the time being, he is utterly unable to recall. Sometimes 
after severe acute diseases the memory for a time is left a blank. In 



254 THE NEW MEDICAL WORLD. 

some cases there is ability to recall the remote events of childhood, 
but no ability to recall the events of the present or immediate past. 
This may be due to the deterioration of the brain in old age, or to 
softening of the brain, and is known as amnesia. 

Numbness and Prickling. — These may be due to pressure upon 
some large nerve. Numbness occurs in many nervous affections, in 
poisoning, in lesions of the brain, or of the spinal cord. 

Hemiplegia. — This is a form of paralysis involving one side, or 
half of the body. It may result from embolism or from apoplexy. 
Embolism is the plugging of an artery by a clot. It causes arrest of 
nutrition, followed by softening of the brain. 

Paraplegia. — This is a paralysis of the lower half of the body, 
and results from disability of the spine. It is due to inflammation, 
hemorrhage, or pressure from some cause, as syphilitic tumors. It 
comes on suddenly, or gradually, and it may be complete or partial. 
It may be due to disease of the membranes of the spinal cord, or to 
pressure from dislocation of a vertebra, or from a tumor or growth 
which cuts off connection with the nerve of the lower extremities. 

Locomotor Ataxia. — This is a disease of the spinal cord. It is 
due to organic changes which take place in the posterior portion of 
the cord, causing atrophy and degeneration. These changes take 
place gradually, the disease reaching over several years. A harden- 
ing process takes place which affects the circulation, the nutrition 
and the muscular movements. The patient is unable to stand or 
walk in the dark or with the eyes shut. The locomotion is chiefly 
affected and is peculiar. In the early stages there are deep seated 
pains about the thighs, legs and back, which are mistaken for rheu- 
matism. The disease may exist fifteen or twenty years. It is thought 
to result from dissipation and abuse of the sexual organs. It is some- 
times the result of syphilitic disease. . The treatment in such hopeless 
eases is unsatisfactory, the preparations of gold and electricity per- 
haps doing as much good as anything. 

Facial Paralysis. — This may be due to pressure upon the great 
nerves which supply the face. The features are distorted and drawn 
either toward the right or left, usually only one side being affected. 
It is the contraction of the muscles on the unaffected side which 
causes the distortion. The treatment of these cases is not as encour- 
aging as of many other affections. Electricity will benefit some 



THE NEW MEDICAL WORLD. 255 

cases, and perhaps cure some of those of more simple degree. Phos- 
phorus and strychnia are powerful remedies to nourish and stimulate 
disabled nerves, but their use should be left in the hands of the 
medical practitioner. Other forms of paralysis are known to physi- 
cians such as writer's cramp, wasting and shaking palsy, different 
forms of paralysis of the aged, infantile paralysis, etc. 

Congenital Defects. — Congenital defects of the brain are of con- 
siderable interest to the physician, and such defects together with 
other deformities may be appropriately noticed here. Congenital 
defects exist at birth, and sometimes are of such a serious character 
as to limit the duration of life to a few hours, days, months, or years. 
Hydrocephalus may exist at birth, and indicates usually a brief exist- 
ence. Other defects of the brain may exist, or there is in rare 
instances an imperfect development of the brain, or an absence of 
the brain itself. When this latter condition exists, independent 
existence cannot be established, and as soon as the link connecting 
the circulation of mother and child is severed death ensues. Respira- 
tion cannot be established nor can the heart beat be excited without 
the controlling energy and force of the great nerve centers. Other 
congenital deformities may be a failure of the spine to close at some 
portion, causing a tumor at that point (spina bifida). Congenital 
defects, such as hair lip and cleft palate are of more frequent occur- 
rence. Congenital defects of the heart sometimes exist, so that life 
is continued but a brief period. Such defects are sometimes confined 
to the organs of generation, and many of these can be remedied by 
the surgeon, while others are too serious to remedy. This, however, 
is to be remembered by the prospective mother, that such defects are 
occasional, and belong to the exception rather than the rule. No one 
should allow life to be clouded by fear of such defects or deformities, 
and brooding over them may be the chief factor in their production. 



CHAPTER XIII. 

THE EYE, ITS APPENDAGES AND DIS- 
EASES. 



I. — Description of the Eye : 1, The Orbits ; 2, The Optic 
Nerves; 3, The Sclerotic; 4, The Choroid; 5, The Iras; 
6, The Ciliary Muscle or Ligament; 7, The Ciliary 
Process; 8, The Retina; 9, The Interior of the Eye; 
10, The Appendages of the Eye. 

II. — Examination of the Eyes; Errors of Refraction: 1, 
Myopia Ob Xear Sight; 2, Hypeemetropia or Far Sight; 
3, Presbyopia or Old Sight; 4, Astigmatism. 

III. — The Use of Glasses, and Directions for Testing the 
Eyesight. 

IV. — Care of the Eyes. 

V. — Diseases of the Eye; 1, Ulcers; 2, Paralysis; 3, Twitch- 
ing OP the Lids; 4, Inflammation op the Eye; 5, Stye; 6, 
Blepharitis; 7, Wounds of the Eyelids; 8, Conjunct- 
ivitis or Ophthalmia; 9, Purulent Ophthalmia; 10, 
Granular Ophthalmia or Granular Lids. 

VI. — Foreign Bodies in the Eye. 

VII. — Inflammations of tin: Cornea (Corneitis): 1, Ulcers 
of the Cornea; 2, Corneal Opacities; 3, Staphyloma. 

VIII. — Inflammation of the Iris or Iritis. 

IX. — Inflammation of the Choroid. 

X. — Sympathetic Inflammation. 

X I. — Glaucoma. 

XII. — Inflammation of the Retina. 

XI 1 1. — Inflammation of the Optic Nerve. 

XI V.— C itaract. 

XV. — Cross Kve, SQUINT OB STRABISMUS. 

XVI. — Various Otheb Affections: L, Growths; 2, Inflamma- 
tion of the Teab Duct; 3, Abscesses of the La« hrymal 
Sack. 



THE NEW MEDICAL WORLD. 257 

I.— DESCRIPTION OF THE EYE. 

THE apparatus for vision is both ingenious and complex. The 
eye is a beautiful and wonderful organ. This description of it 
includes not only the apparatus for seeing, but also the appendages 
of the eye. 

In simple language, each eyeball forms a hollow sphere, composed 
of three layers, or tunics. The inside layer is blackened over by 
deposits of pigment, so that pictures . are formed upon its surface. 
The interior of the eyeball contains fluid material and a double 
convex lens, which lies behind the two chambers of the eye and con- 
verges the rays of light, so that a distinct image is formed upon the 
retina, which is conveyed to the brain by the optic nerve. 

The light passes from without in order, through the cornea, the 
aqueous humor, the chrystalline lens, the vitreous humor, and is 
focused upon the back part of the eye, where the images or outlines 
of objects are formed. This outline or impression is carried to the 
brain by the optic nerve, and a sensation is awakened which we call 
vision. 

There are some things pertaining to this process which are difficult 
to explain to the ordinary reader. 

The amount of light admitted to the eyes is regulated by the iris. 
The iris is so sensitive that it contracts the pupil when the light is 
too bright, and enlarges it when the light is too dim to produce 
perfect vision. In this way the rays are diminished or increased, as 
the requirements of perfect vision demand. A muscular arrange- 
ment also increases or diminishes the convexity of the lens so that 
objects can be seen far away as well as near at hand. Muscles are 
attached to the eyeballs which rotate them sufficiently to enlarge the 
field of vision and permit a wide survey at the same instant. 

The two eyes also act in such harmony that the images formed 
upon each retina, though slightly different, are blended into one 
symmetrical whole. This is, in brief, a description of the apparatus 
for vision. It is very similar to the method employed in taking 
pictures with the camera obscura, which was no doubt suggested by 
a study of the human eye. 

The Orbits. — The orbits are the bony cavities which give a secure 
abode for the eyeballs. They are shaped like pyramids, with the 
base in front and the apex extending backward toward the brain. 
Through an opening, called the optic foramen, at the apex, the optic 



258 THE NEW MEDICAL WORLD. 

nerve enters, accompanied by blood vessels, both essential to the func- 
tions of the eye. The orbits are lined with periosteum, and contain 
considerable connective tissue and fat, which forms an easy bed for 
the eye to rest upon, and favors its natural movements. 

The bony structures, so prominent about the eyes, serve to protect 
these important organs from harm. 

The Optic Nerve. — The optic nerves compose the second pair of 
cranial nerves ; they have nothing to do with motion or sensation. 
They are nerves of special sense. The optic nerve, accompanied by 
an artery, penetrates the back part of each eyeball, and is spread out 
upon the retina so as to make it very sensitive to impressions, and for 
this reason the retina is sometimes termed the sensitive coat or tunic 
of the eye. Division of the optic nerve causes immediate blindness. 

The Sclerotic. — The sclerotic is the outside coat or tunic of the 
eye, and forms its structure ; it is called the fibrous tunic. It receives 
its name on account of its density and hardness. It is the toughness 
of this tissue which enables the eyes to preserve the shape of a globe. 
The sclerotic makes up about five-sixths of the external surface of 
the eyeball. The remaining one-sixth is situated directly in front, 
and is called the cornea. This is a continuation of the sclerotic, but 
for the purpose of vision is transparent. It is sometimes called the 
window of the eye, because it admits the rays of light. It sits upon 
the globe somewhat like the crystal of a watch, being the segment of 
a smaller sphere. 

Around the margin of the cornea the sclerotic is seen as a white, 
glistening surface, which is known as the white of the eye. The 
cornea is composed of five distinct layers. 

The Choroid. — Directly within the sclerotic coat is the choroid. 

This is a thin, delicate membrane, but so liberally supplied with blood 
vessels that it is sometimes called the vascular tunic. It has four 
separate layers. The choroid extends over the whole back part of 
the eyeball and reaches as far forward as the cornea. It terminates 
in the ciliary ligament, the ciliary processes and the iris. 

The Iris. — It is a continuation of the choroid, and is a circular 
muscular curtain, which hangs vertically behind the cornea, and in 
front of the crystalline lens. 

It has an opening in the center called the pupil. The iris is differ- 
ently colored in different persons by pigments, which accounts for 



THE NEW MEDICAL WORLD. 259 

the great variety of color and beauty of the human eye ; some eyes 
appearing to be very light, and others blue, brown, hazel or black. 
The pupil is simply an opening in the center of the eye, which varies 
in size with the contraction or dilation of the iris. It appears to be 
black, because when standing in front of a person and looking into 
the eye the rays of light are intercepted, and you look into a dark 
chamber. 

The Ciliary fluscles or Ligaments. — These are a continuation 
of the choroid, and cause the contraction and dilation of the iris, and 
hence are the prominent factors in accommodation. 

The Ciliary Processes. — They are a continuation also of the cho- 
roid, and are composed of a circle of folds behind the iris, attached 
to the ciliary muscle and surrounding the margin of the lens. 

The Retina. — Within the choroid is the retina ; it forms the third 
or inner tunic of the eyeball, and from the fact that the optic nerve 
is spread out over this membrane it is sometimes called the sensitive 
tunic. It is a thin membrane, composed of three layers and very 
liberally supplied by nerves. It lines the interior of the globe from 
the optic nerve as far forward as the ciliary ligaments. 

The whole surface of the retina is blackened over by deposits of 
pigment and, with the exception of a point where the optic nerve 
passes through it, it possesses the power of receiving visual impres- 
sions. This point is called the blind spot. The terminal fibers of 
the optic nerve are gathered together in bundles upon the retina, and 
from their resemblance are known as the layer of rods and cones. 

The parts above described, viz. : the sclerotic, choroid and retina 
form the three tunics or coverings of the eyeball, also known as the 
fibrous, the vascular and the sensitive tunics. 

The Interior of the Eye. — In the interior of the eye are the 

aqueous humor, the crystalline lens, and the vitreous humor ; these 
are known as the refracting media or humors of the eye. 

The aqueous humor is a clear, saline fluid and fills that portion of 
the eye between the cornea and crystalline lens known as the anterior 
and posterior chambers. The vitreous humor fills all the cavity of 
the globe back of the lens. , It is perfectly transparent and about the 
consistency of thin jelly. It occupies four-fifths of the space in the 
eyeball. 



2CU 



THE NEW MEDICAL WORLD. 



The crystalline lens is situated behind the pupil, or opening in the 
iris. It is a transparent body, biconvex, or convex on both sides. It 
is enclosed in a capsule, and is held in place by the suspensory liga- 
ment. This lens is about a quarter of an inch in diameter. It sepa- 
rates the aqueous from the vitreous humor. The lens, acted upon by 
its muscular surroundings, has the power of increasing or diminish- 
ing its convexity, in order that a vision may be obtained of near or 
remote objects. The power imparted to the eye by the ciliary liga- 
ment, which dilates and contracts the iris, and by the suspensory 
ligament which increases or diminishes the convexity of the lens, is 
known as accommodation. By means of this faculty we can see 
objects far away as well as near at hand, for the rays of light are 
brought to a focus upon the retina whether we are reading a book or 
looking at some far away object. Some deficiency in the power of 
accommodation is a common fault of many eyes. 

The motion of the eyeballs is due to six muscles, four recti and two 
oblique. The muscles of both eyes usually act in harmony. When the 

muscles do not act in harmony, 
owing to a loss of power, the 
result is a condition known as 
strabismus or squint. These 
muscles have their origin in the 
tissues about the apex of the 
orbits, and are inserted into the 
sclerotic a short distance back 
of the cornea. The oblique 
muscles run through a ring 
which acts as a pally, and in- 
These muscles combine to give a wide range 




8ectiou of the eyeball showing its internal 
structure and the entrance of optic nerve. 



creases the leverage 
of motion to the eye. 

The various appendages of the eye are worthy of notice in this 
connection. The eyebrows are prominent ridges of skin on the 
upper borders of the orbits. They support a growth of short hairs, 
and are connected with certain muscles which somewhat control the 
amount of light admitted to the eye. The eyebrows are often marks 
of beauty. 

The eyelids are two thin folds which Open and close to protect the 
eye from injury. The upper lid is larger and more movable than 
the lower. The skin of the eyelids te thin, and beneath it there i^ 



THE NEW MEDICAL WORLD. 261 

some connective tissue, muscular fibers, cartilage, vessels, nerves and 
glands, lined up on the inside with a thin mucous membrane known 
as the conjunctiva. This not only lines the eyelids, but is reflected 
over the front portion of the sclerotic and cornea. That portion 
which covers the cornea is extremely delicate and does not appear to 
contain any blood vessels. Along the margin of each lid is a row of 
fine hairs, the eyelashes. The eyelids when open form an elliptical 
space, and the angles formed by the junction of the upper and lower 
lids are called the outer and inner canthus respectively. The inner 
canthus contains a small, triangular space, and on the margin of 
each lid is a little elevation with an orifice which is the commence- 
ment of the tear duct. Between the cartilage of the lids and the 
conjunctiva a row of glands is situated which may be seen by evert- 
ing the eyelid, the Meibomian glands. There are between twenty 
and thirty in each lid. They open by means of little tubes on the 
borders of the lids. They secrete an oily fluid, which prevents the 
eyelids from sticking together. The eyelids are moved by means of 
delicate muscles which open and close the lids involuntarily, as in 
winking. 

This act washes over the surface of the cornea, removes particles 
of dust, and also prevents the cornea from getting dry. The eyelids 
are abundantly supplied with delicate nerve branches and blood 
vessels. 

In the inner canthus of the eye is a small, reddish, triangular eleva- 
tion, containing a cluster of follicles, covered with mucous membrane. 
These follicles secrete a fluid substance which collects in the inner 
corner of the eye. The lachrymal or tear gland is about the size and 
shape of an almond, and is situated in a depression above the outer 
canthus or angle. Seven or more little ducts, opening at the reflec- 
tion of the conjunctiva upon the sclerotic, connect this gland to the 
surface of the eye and convey the tears which it secretes. Unless 
the secretion is excessive this fluid is carried away in little canals 
into the cavity of the nose. But in excessive grief there is an over- 
flow of these tears upon the face, as seen in the act of crying. 
Sometimes there is an obstruction of the canal which conveys 
away the tears, and then there is the condition known as watery 
or weeping eye. In old age the eye loses a great measure of its 
luster; the cornea and lens become flattened, rendering glasses a 
necessity for distinct vision. Near the outer margin of the cornea 
a grayish circle forms, called the " arcus senilis," and is the 



262 THE NEW MEDICAL WORLD. 

result of degenerative changes. Other similar changes take place 
to render the eye dim and vision less satisfactory in old age. 

II. — EXAMINATION OF THE EYES. ERRORS OF RE- 
FRACTION. 

The eye is one of the most delicately constructed organs of the 
human body, and while it is advisable to learn as much as possible 
about its different diseases, it is earnestly recommended that only 
skilled persons attempt to treat any except the most slight affections 
of this organ. Even to examine the eye thoroughly requires a large 
amount of practice and considerable skill. 

For the examination of the interior of the eye the ophthalmoscope 
is everywhere extensively used. It is a concave mirror with an 
opening in the center. By means of this instrument light can be 
thrown into the back portion of the eye, and the optic nerve, the 
blood vessels and the retina become visible. The pupil of the eye is 
usually dilated with a solution of atropia before the examination is 
attempted. 

The ophthalmoscope is an instrument of great importance, also for 
the diagnosis of certain diseases of remote organs, which first cause 
a disturbance in the delicate tissues of the eye. A skillful examina- 
tion of the eye enables the examiner to detect the existence of 
Bright' s disease and other important affections. 

The appendages of the eye are readily examined and a diagnosis 
of conjunctivitis and other similar affections is easily made. The 
upper lid can be everted by lifting and turning it over the end of a 
probe or pencil. This is often essential in searching for some foreign 
bodv beneath the evelid. 

Myopia. — (Near Sight). — This is a congenital affection. It is 
that condition in which the rays of light entering the eye are brought 
to a focus in front of the retina. The patient can see only near 
objects distinctly, because the rays are brought to a focus too much 
in front of the retina for remote objects. 

Hypermetropia. — (Far Sight) — This is the opposite of the con- 
dition just mentioned. The raya of light do not converge enough to 
come to a focus upon the retina. The ciliary muscle cannot increase 

the convexity <>t* the lens sufficiently to see near objects distinctly. 
Hence the rays of lurht come to a focus behind the retina and vision 




Lines to test the existence of astigmatism. 




Other lines to detect astigmatism. 



264 



THE NEW MEDICAL WORLD. 



is indistinct. The attempt to see near objects wearies the muscles, 
produces headache and perhaps pain in the eyes, or eye-strain. Re- 
mote objects may be seen by the hypermetropic eye distinctly without 
strain, pain or weariness. 

Presbyopia. — (Old Sight). — In this condition the patient does 
not see well, because the cornea is flattened and the lens does not 
respond to the action of the ciliary muscle sufficiently to increase its 
convexity. The vision is poor for near objects. 

Astigmatism. — In this condition the cornea is not spherical, being 
warped, so to speak, and some rays of light entering the eye come to 
a focus sooner than others. This causes indistinct vision. 

Examinations show that persons suffering from astigmatism can 
see horizontal lines more perfectly than perpendicular lines. The 
lines here represented may be used to detect this affection. Lines 
are also arranged in a circle radiating from a center about the size of 
a clock face. Some of the lines will appear blurred or indistinct if 
the eyes are astigmatic. Specially prepared or prismatic glasses are 
necessary to correct astigmatism. 



III. — THE USE OF GLASSES AND DIRECTIONS FOR 
TESTING THE EYESIGHT. 

Errors in refraction, as they are termed, are all nicely remedied by 
glasses suitably constructed and fitted. 

These conditions can be made out by test cards or trial glasses. 
Myopia or near sightedness requires the use of concave glasses. 
Hypermetropia or far sight and presbyopia or old sight can also be 
remedied by well fitting glasses. Weakness of vision is usually due 
to some debilitating sickness, or overwork of the eyes, especially 
where some error of refraction exists. Loss of vision is usually due 
to organic disease of some of the tissues of the eye, and cannot be so 
easily remedied. 

To use the eyes in a weak condition may result in changing an 
acute trouble to a chronic one, rendering a temporary affection per- 
manent. It is often advisable to wear glasses during a temporary 
weakness of the eyes to prevent permanent injury, especially if com- 
plete rest is inexpedient and cannot be enjoined. 

Imperfect and defective vision is largely the result of civilization. 
Close attention to books in schools is a prominent cause of the wide- 
spread and increasing affection known as myopia. 



THE NEW MEDICAL WORLD. 265 



Hold this page, fourteen inches away from the eves in a good 
light and select the smallest type that can be distinctly read with 
«ase. The figures at the rio;ht show the focus and the number of 
glasses needed : 



No. 1. 

For ace and want sare while you may, no morning sun lasts all the day. O0" = l)0 



No. 2. 

Work to-day for you kno\r not how much, you may be hindered to-morrow. 50"00 



No. 3. 

If you would have a faithful servant, and one that you like, serve yourself. 40-4& 



No. 4. 

Experience keeps a dear schQol, but fools will learn in no other 3G-4G 



No. 5. 
Industry needs not wish, and he that lives upon hope will die fasting. 30-36 



No. 6. 

Want of care does us more damage than want of knowledge. 24-30 



No. 7. 

If you would know the value of money, try to borrow some. 20-24 



No. 8. 

"What maintains one vice wonld bring up two children. 1 8-20 






E T L F 



P Z E D B 



O L T Z B D 



A C E O L N P 



268 THE NEW MEDICAL WORLD. 

The power of vision is determined by means of cards containing 
letters of various sizes, which the normal eye can distinguish at a 
certain distance away. 

A normal eye ought to distinguish the large letter B at a distance 
of fifty (50) feet ; the next in size, D and E, at a distance of thirty 
(30) feet; the next in size, B and T, at a distance of twenty (20) 
feet; and the next in size, B, E and F, at a distance of fifteen (15) 
feet. The remaining letters in the four last lines should all be dis- 
tinguished at a distance of thirteen (13) feet. Onty one eye should 
be tested at a time ; the other eye may be closed by the fingers. 

Another practical method is the following : 




fen 





Snellen's test type, to be seen distinctly at a distance of twenty feet. 
If these letters can be distinctly seen at a distance of twenty feet 
there is but little, if anj r , defect of vision. If the patient is unable to 
see these letters distinctly at the distance mentioned he may be near 
sighted and need glasses. 

Jaeger's Test Types — The method of testing the eyes by means 
of sentences printed in different sized tj'pe is practical. If the size 
of No. 1 cannot be read at any distance there is some fault of vision. 
If it is easily read at a distance of eight inches the vision is normal; 
if it can be easily read at a less distance than six inches the patient is 
probably near sighted; if it can only be read by holding it away 
more than eight inches the patient is far sighted. 

IV._CARE OF THE EVES. 

The care of the eyes is exceedingly important, especially in th*> 
case of children. 

Heading and fine work require plenty of light. It is better for the 
rays of light to fall over the left or right shoulder than to come from 
in front of the eyes. 

The eyes are often strained or weakened by attempting to read in 
the twilight, or when the source of light i-< too far away. The eye is 
injured by reading upon moving trains, which, by their unsteadiness 
of motion, constantly change the focus and render reading difficult 
and tiresome. Hooks printed in very small type, or badly blurred, 



THE NEW MEDICAL WORLD. 269 

so as to be indistinct, should be avoided. Reading in bed is not a 
good habit. The position is unsuitable, the light unfavorable, and 
the eye is subjected to unusual strain, besides the danger of falling 
asleep and setting the house on fire. 

Riding against the wind is sometimes injurious, and may cause 
congestion of the tissues about the eye. A foul atmosphere, or one 
filled with smoke, vapor, dust, or gas, is bad for the eyes. The vapor 
of acid is also injurious. The glare of the sunlight, especially upon 
the seashore, or from the pavements of the city, is trying, and the 
eyes should be protected from excessive light by a broad brim hat or 
appropriate glasses. The light reflected from fields of snow and ice 
is also trying, and requires their protection. 

The eyes should receive especial care after certain diseases, as 
measles, scarlet fever and small pox. 

The eyes are often weak during pregnancy, and for a long time 
after confinement. When the eyes are weak as the result of some 
especial tax upon the nervous system, or some disease, their use 
should be regulated and reading and study prohibited for a suitable 
period. 

The eyes should be kept clean. It is safe to bathe them in warm 
or cold water, and for severe pain in the eye hot water may be 
applied for a few minutes every' hour. The continuous use of moist 
heat, as produced by a poultice, is dangerous, and ought not to be 
employed, except advisedly, since it is liable to soften the delicate 
tissues and do great harm, or even destroy the sight. For eyes that 
are easily inflamed, an application of water, containing a little com- 
mon salt, is said to be beneficial. A teaspoonful of salt to a quart of 
water is sufficient, and may be applied once or twice a day. 

The habits exert their influence upon the eyes as well as upon the 
other tissues of the body. Incessant smokers and drinkers are liable 
to have diseases of the retina and optic nerve. Excessive sexual 
indulgence is liable to have a debilitating influence upon the eyes. 
Insufficient food, overwork, or whatever produces a profound im- 
pression upon the system, is liable to have a corresponding effect 
upon the eyes, for they are very sensitive to our habits, and sympa- 
thize with any constitutional impairment. General attention to the 
health, as exercise, bathing, nutritious food and correct habits, find 
corresponding approval and response in the eyes. 

Life in the country strengthens the eyes and trains them for far 
vision, while life in the city favors myopia. Constantly looking at 



270 THE NEW MEDICAL WORLD. 

near objects favors near sight, while looking far out and away, over 
Held and landscape, helps to perfect the eye and adapt it to a wide 
range of vision. When performing work which is difficult and 
exacting, frequently look away for a second, as this relieves and rests 
the eyes. 

Y.—DISEASES OF THE EYE. 

Diseases of the eye and its appendages form a numerous class. 
Some of them, owing to difficulty of treatment or to their rarity, will 
be only briefly noticed. 

Ulcers. — Ulcers occur upon the eyelids, sometimes as the result of 
syphilis. These are to be treated as similar ulcers elsewhere. 

Paralysis. — Paralysis of the nerves which control the eyelids may 
occur. There is inability to close the lids. The lower lid falls away, 
the eye fills with tears and overflows owing to the displacement of 
the tear duct. 

The treatment for this affection is the administration of strychnia, 
one-sixtieth of a grain three times a day, also the external application 
of electricity. 

Twitching of the Lid. — This may be due to some affection of the 
cornea, or it may result from some nervous state or indigestion. The 
treatment requires attention to the general health, and the correction 
of any errors of refraction by glasses. 

Inflammation of the Eyelids. — This may result after measles, 
scarlet fever, erysipelas, or from injuries or severe neighboring 
inflammations. This condition demands attention to the general 
health, cooling and soothing lotions. 

Stye. — This generally occurs in persons <>f delicate health. It 
consists of a small red and painful swelling due to the closure and 
inflammation of the outlet of one of the glands. When pas has 
formed the stye should be pricked or opened and this will afford no 
little relief. When a succession of styes occurs, they indicate that the 
general health should receive attention, and suitable tonics should be 

administered. 

Blepharitis. — This disease of the lids is characterized by the 

formation <»t* dry crusts or scales along their margin about the eye 

lashes. If these crusts are forcibly removed they leave an ulcerated 
ami bleeding surface about the hairs, and sometimes the lids become 



THE NEW MEDICAL WORLD. 271 

thickened along the margins. This disease occurs often among 
unthrifty children, and is very chronic in its course, sometimes resist- 
ing all remedies. It is sometimes caused by eye strain due to errors 
in refraction, and yields to the adjustment of glasses. A lotion con- 
taining four or live grains of alum to an ounce of water may be used 
three or four times daily. The crusts should all be removed, and 
then apply an ointment containing one grain of the yellow oxide of 
mercury to one ounce of vaseline. 

| 

Wounds of the Eyelids. — These should be cleansed by an anti- 
septic solution and sewed up with fine silk. The stitches should be 
carefully removed after three or four days. 

Injuries produced by blows cause a rupture of some of the small 
blood vessels in the soft tissues about the eye, and an extensive 
extravasation of blood, called ecchymosis or black eye. Time will 
cause the absorption of the blood, or the result may be hastened by 
the following lotion : 

fy Chloride of ammonia one dram 

Water one pint 

Mix and apply on a piece of muslin. 

Conjunctivitis or Ophthalmia. — There are a number of varieties 
of this affection, but in all the eyes are red and inflamed. There is 
pain of a smarting, " itching character, and the eyelids are glued 
together by the discharges of the glands during sleep. 

This affection is best treated by astringent lotions, and the more 
chronic the trouble the stronger they may be. Weak lotions are 
sufficient for mild acute cases. The following are harmless and often 
beneficial : 

5, Alum three grains 

Distilled water one ounce 

Mix and use as eye wash. 

^ Sulphate of zinc one or two grains 

Distilled water one ounce 

Mix and use as eye wash. 

A little vaseline may be used on the margin of the lids each night 
to prevent them from being glued together. Many other remedies 
are used by the surgeon, but these here recommended are mild and 
can be used by any one without danger. Catarrhal ophthalmia is 



272 THE NEW MEDICAL WORLD. 

the most common variety, and is caused principally by taking cold. 
The disease often commences in one eye, extending soon to the other. 
It spreads from one person to another by using the same towel, and 
in other ways. The above lotions are suitable for this affliction. If 
there is much smarting a grain of cocaine may be added to either 
prescription for its relief. 

Purulent Ophthalmia. — This occurs in new-born children, and 
is due to the inoculation of the eye with the acid secretions of the 
vagina. The worst form is where the secretions are gonorrheal. 
The disease appears a few days after birth. The eyelids are swollen ; 
the conjunctiva is highly congested; the eyes cannot bear the light; 
they are opened with difficulty, and there is an abundant discharge 
of whitish or yellowish matter. This affection among new-born chil- 
dren is known as ophthalmia neonatorum. There is much danger of 
implication of the cornea, which is sometimes destroyed, and the 
sight is lost. 

Treatment. — Wash out the eye every hour during the day with 
a strong alum lotion : Alum, ten grains ; water, one ounce, and apply 
vaseline or some simple ointment to the lids. 

The conjunctiva is sometimes inflamed by hot lime or metals spat- 
tering into the eyes. 

Examine the eye thoroughly and remove all foreign particles. For 
slacking lime, wash the eye thoroughly in water to which a little 
vinegar has been added. Then place a drop or two of sweet oil 
between the lids. 

Granular Ophthalmia. — This is a disease which often results 
from unfavorable hygienic surroundings, and the crowding together 
of individuals in workshops, schools, and in the army. It is char- 
acterized by the enlargement of the little follicles in the conjunctiva 
which covers the eyelids, these appearing as little concave elevations 
in a state of inflammation. They sometimes irritate and injure the 
cornea, so as to destroy a measure of its transparency. The treat- 
ment used by the oculist is the thorough removal of the granulations 
without destroying the surrounding tissue. This is accomplished by 
applying the mitigated nitrate of silver stick twice a week, and using 
the following astringent lotion : 

ty Sulphate of copper two grains 

Water one ounce 

Mix and apply four or five times a day. 



THE NEW MEDICAL WORLD. 273 

Many eyes have been permanently injured by incompetent treat- 
ment. Other affections may complicate the existing trouble and 
require the exhibition of extraordinary skill. 





Conjunctivitis, showing congested blood Iritis, showing change in shape of 

vessels. pupil. 

VL—FOREIGN BODIES IN THE EYE. 

Particles of metal, cinders, the grit from emery wheels and other 
substances often strike the eye with such force as to become imbedded 
in the conjunctiva or cornea. They can be removed by a soft piece 
of cloth or by the surgeon with a spud or a pair of forceps 

If the eye is much inflamed and intolerant of the light a little 
cocaine solution dropped into it a few minutes before attempting to 
remove the foreign body greatly facilitates the operation. 

VII.— INFLAMMATIONS OF THE CORNEA (CORNEITIS). 

Many diseases of the eye involve the cornea. They derive their 
importance from the fact that any impairment of the transparency of 
the cornea affects the vision unfavorably. There are several varieties 
of corneal inflammation. It is sometimes caused by injuries, as the 
lodging of foreign bodies upon or in the corneal tissue. There is 
pain, intolerance of light, an increase of tears, and a dull or hazy con- 
dition of the cornea, Avith congestion of the blood vessels surrounding 
the cornea. It is sometimes associated with inflammation of the iris. 

Inflammation of the cornea may be suppurative. This is usually 
caused by some injury, as a blow from a twig, or some other sub- 
stance. It also results from great debility, after severe sickness, as 



274 THE -NEW MEDICAL WoKLD. 

fevers, or it develops in those who have suffered for lack of food, or 
those who inherit scrofula or syphilis. Cases of such grave import 
should be submitted to a competent oculist. 

Foreign bodies or other irritating causes should be removed. Con- 
stitutional remedies should be given, such as iodide of potash, and 
iron in pill form. The eye needs rest, protection from the light, and 
such other treatment as the symptoms indicate. 

Ulcers of the Cornea. — These occur in great variety. They may 
be superficial, or involve all the layers of the cornea. They may be 
small or large, there may be one or several. They may injure the 
transparency of a single point or of the whole cornea. 

Children are more subject 10 these affections than others. They 
occur after acute diseases, as measles and scarlet fever. They may 
result from a debilitated condition of the system, or from some defect 
in the nutrition of the eye. 

The" symptoms of corneal ulcer are smarting pain, intolerance of 
light, increased flow of tears, and the feeling as if there was some- 
thing in the eye. The treatment varies with the condition of the 
patient and the character of the ulceration. The general health must 
be looked after, and the eye needs to be somewhat protected from 
the light. A lotion containing two grains of atropia to an ounce of 
water is much employed. Of this two or three drops are used in the 
eye quite frequently. A sloughing ulcer sometimes extends rapidly, 
and if not arrested perforation of the cornea takes place, followed by 
prolapse of the iris and loss of sight. To prevent this unfortunate 
occurrence surgeons resort to one of the following operations: The 
puncturing or tapping the cornea with a.needle and allowing some of 
the fluid to escape. This relieves the pressure on the cornea from 
behind. Or, to iridectomy, which is the name given to the removal 
of a portion of the iris. 

Corneal Opacities are either the result of injuries, inflammation 
or ulceration. The cornea is found, after healing, to have lost more 
or less of its transparency, and to have become hazy or cloudy. This 
condition may be present in varying degrees from a slight cloudiness 
to a dense white opacity, involving the entire cornea. Slight corneal 
opacities may improve or nearly disappear, as in the ease t^i children, 
and their removal may be aided by applications which favor absorption. 

Staphyloma. — This is the name given to a bulging of the cornea, 
from its fancied resemblance to a grape. It causes great disfigure- 



% 

THE NEW MEDICAL WORLD. 275 

ment of the eye and is itself caused by ulceration of the cornea and 
prolapse of the iris. When the whole cornea bulges forward the 
disease is said to be total ; if only some portion of it, it is said to be 
partial. The treatment of this affection when total is the removal of 
the eye, to prevent the sound eye from becoming diseased also. 

VIII.— INFLAMMATION OF THE IRIS OR IRITIS. 

There are three varieties of iritis : simple, rheumatic and syphilitic. 
There are several causes which may produce it, as an extension of 
irritation from foreign bodies in the conjunctiva or cornea, friction 
due to granulations upon the lids, injuries from accidents or opera- 
tions, debility after disease, rheumatism, gout and syphilis. 

SYMPTOMS. 

These are a changed color of the iris, more or less severe pain, con- 
traction of the pupil, a redness around the border of the cornea, 
dimness of vision, and intolerance of light. A simple attack may 
last from one to two weeks, or even longer. There is danger of 
adhesions forming between the iris and crystalline lens. 

Rheumatic iritis occurs in those persons who are subject to gout or 
rheumatism. It tends to reappear again and again in the same indi- 
vidual, and from this fact it is termed recurrent iritis. It is some- 
times accompanied by very severe pain in the eyeball. Its most 
distinguishing characteristic is its tendency to recur without any 
apparent cause, which is prevented by the operation of iridectomy. 

The most common variety of iritis is the syphilitic. 

TREATMENT. 

The treatment should be directed to the removal of the cause, if it 
can be ascertained. This may be some foreign body which excites 
the inflammation, or irritation produced by granulation on the lids or 
inverted eyelashes. The pupil should be kept dilated by a solution 
of atropia, one or two grains to an ounce of water, as this prevents 
the iris from adhering to the lens. 

Syphilitic iritis should, in addition, have constitutional treatment 
appropriate to that disease. • Tonics may be necessary in debilitated 
conditions. Anodynes may be required to allay pain. The eyes may 
be protected, if necessary, by a suitable shade. 



276 THE NEW MEDICAL WORLD. 

Many other successful remedies may be used for the benefit of 
individual cases. To mention them would be superfluous, as iritis 
cannot be treated properly by the unprofessional. Iridectomy is often 
necessary, and this delicate operation can only be performed by a 
skillful oculist. 

IX.— INFLAMMATION OF THE CHOROID. 

This is often associated with inflammation of the iris. It is unnec- 
essary to describe this disease as its diagnosis can only be positively 
made by examination with the ophthalmoscope. It is quite com- 
monly caused by syphilis. The treatment is very similar to that of 
iritis. Injuries of the choroid are treated the same as injuries of the 
sclerotic. 

X.— SYMPATHETIC INFLAMMATION. 

This is a peculiar inflammation coming on in the sound eye in con- 
sequence of the injury of the other. After injury of one eye, or the 
lodging of a foreign body within the globe, the other eye may 
become irritable or painful, and inflammation the same as has existed 
in the injured eye succeeds. Much damage or even loss of the unin- 
jured eye is likely to result from sympathetic ophthalmia. 

The way to prevent such an unfortunate result is by the timely 
removal of the injured eye. If the disease has become fully estab- 
lished it is doubtful if the removal of the injured eye will stop the 
progress of the inflammation. This condition requires the advice of 
a competent oculist. 

XT.— GLAUCOMA. 

Glaucoma is a disease of the eye due to an increase of the tension 
of the globe. The cause is not known. It is supposed to be due 
either to an excessive accumulation of the fluids within the eve, or 
else to some defect in their absorption and removal. The symptoms 
are not well marked, and the disease is quite insidious. The power 
<>t' vision is gradually diminished ; also the power oi accommodation 

is lessened, the pupil is dilated and the lens cloudy. Hemorrhages 
may occur from the blood vessels i)\' the retina, and there may be 
acute pain in the eyeball. The eyeball at Length becomes very hard, 

tin' cornea loses its transparency, the humors of the eye become dis- 

COlored and the lens opaque. The disease ends in blindness. The 



THE NEW MEDICAL WORLD. 277 

acute condition is liable to become chronic. It does not come on 
usually before fifty years of age. This disease is not benefited by 
medicines, and requires the operation of iridectomy, which should 
be done early. 

XII.— INFLAMMATION OF THE RETINA. 

Inflammation of the retina is generally the result of some consti- 
tutional disease, as syphilis, or Bright's disease of the kidneys. It 
may, however, occur from the plugging up of the blood vessels, or 
from hemorrhage, or from inflammation of the brain. The vision is 
impaired. Other symptoms are pain, dread of the light and colored 
vision. 

The disease is diagnosed by means of the ophthalmoscope. There 
is sometimes a congested condition of the blood vessels of the retina, 
caused by eye strain, or by working over a hot fire, and constantly 
looking at a bright light. This condition is remedied by rest and by 
protecting the eyes from too much light by a shade or some other 
device. 

Hemorrhage sometimes occurs from the vessels of the retina, a 
vessel becoming ruptured. The blood clot is absorbed in time, but 
rarely so but what traces of the injury remains. 

XIII.— INFLAMMATION OF THE OPTIC NERVE. 

The optic nerve is subject to inflammation or atrophy and paral- 
ysis from pressure of tumor or other diseases of the brain. The 
nature of these affections becomes known only by examination of the 
eye with the ophthalmoscope. The vision is impaired, and partial or 
complete loss of sight may be the result. Some cases are benefited 
by the judicious use of phosphorus, iron and strychnia, also galvanic 
electricity. It seems to be established that the excessive use of 
tobacco may cause atrophy of the optic nerve. The abandonment of 
the narcotic in such a case is followed by improvement. 

XIV.— CATARACT. 

This is a common affection, usually occurring after fifty years of 
age. It is an opacity of the crystalline lens and caused by failure 
of its nutrition. The disease approaches gradually. It may result 
from changes due to age, or from constitutional diseases, or from 



27* 



THE NEW MEDICAL WORLD. 



inflammation in the parts which surround the lens and from which it 
draws nutrition. It also results from injury. When the lens becomes 
opaque the rays of light cannot pass through it to the retina, and 
vision is cut off. 

There are two varieties of cataract, hard and soft. The only symp- 
tom of the disease is a milky appearance in the center of the eye and 
the gradual loss of vision. There is absence of pain. 

TREATMENT. 

When the opacity of the lens is in the center and not complete, 
vision may be improved by enlarging the opening in the iris. This 
is accomplished by the operation of iridectomy, or the removal of a 
portion of the iris. When the whole lens has lost its transparency 
its removal should be undertaken. The operation is a delicate one. 
A cataract knife is passed through the upper half of the cornea near 




Cataract operation 



its junction with the sclerotic. A portion of the aqueous humor 
escapes through the wound. Next a cystotome is introduced and 
the capsule of the lens is lacerated. This allows the lens to escape 
forward, and by skillful manipulation it advances through the rut 
made by the knife in the cornea. The eye is then bandaged, and 
after recovery a convex lens in front of the eye restores its vision if 
the operation has been successful and the eye is otherwise sound. 



THE NEW MEDICAL WORLD. 279 

XV.— CROSS EYE, SQUINT OR STRABISMUS. 

This is a common defect, and is caused by inequality in the strength 
of the muscles, which control the movements of the eye. 

The two varieties of cross eye most frequently seen are convergent 
and divergent. In convergent squint the eye turns inward toward 
the nose, in divergent squint it turns outward. It is sometimes diffi- 
cult to tell which eye is at fault, but various methods in use avail for 
this purpose. 

TREATMENT. 

Unless the degree of squint be slight, it can only be remedied by 
an operation. The muscle which contracts with the most strength, 
pulling the eye too far out or in, is divided at its tendinous insertion 
into the sclerotic. Before this can be done a little cut is made 
through the conjunctiva just in front of the muscle, a blunt hook is 
passed into this opening, the muscle is brought into view and wholly 
or partly divided with a pair of curved scissors close to the sclerotic. 

It is often necessary to fit glasses to correct the vision, conrplete 
the success of the operation and prevent the recurrence of the trouble. 
It is sometimes necessary to repeat the operation or to perform it 
upon both eyes in bad cases. 

XVI.— VARIOUS OTHER AFFECTIONS. 

Growths — Tumors, growths and cancers within or about the eye- 
ball are not of frequent occurrence, but they usually require the 
removal of the eyeball sooner or later, and hence should be submitted 
to the care of an experienced hand. It would be impossible to 
describe all these rare affections fully enough to be of service to non- 
professional readers. 

Suppuration sometimes occurs within the eyeball, and rapid failure 
of vision results, accompanied by severe pain. The sight is gener- 
ally lost, whether the pus is evacuated through an opening made or 
left to rupture its way out. 

Inflammation of the Tear Duct. — This may be caused by injury 
or burns and tears overflow upon the cheek owing to the obstruction 
of the canal. The obstruction is removed by slitting the canal with 
a narrow knife. 



280 THE NEW MEDICAL World. 

Abscesses of the Lachrymal Sac. — The lachrymal sac-, situ- 
ated under the inner corner of the eye beside the nose, is sometimes 
the seat of an abscess due to inflammatory action. The pus should 
be evacuated by an opening into it, or by slitting the canal and 
allowing it to escape. 

If the abscess takes its own course and ruptures through the skin 
a fistulous opening is liable to be established. 



CHAPTER XIV. 
THE EAR AND ITS DISEASES, 



I. — Description of the Ear: 1, The External Ear; 2, The 
Auditory Canal ; 3, The Middle Ear or Tympanum ; 4, 
The Eustachian Tube and the Ossicles ; 5, The Internal 
Ear or Labyrinth. II. — Diseases of the Ear: ^Deaf- 
ness; 2, Impacted Wax or Cerumen ; 3, Foreign Bodies 
in the Ear; 4, Inflammation of the Ear; 5, Polypi. 
III. — Diseases of the Middle Ear: 1, Rupture of the 
Drum; 2, Acute and Chronic Catarrh of the Middle 
Ear or Otitis Media; 3, Inflation of the Middle Ear; 4, 
Congenital Defects of the Ear. IV. — Mastoid Disease. 

I.— DESCRIPTION OF THE EAR. 

THE ear exists for the purpose of collecting and conveying the 
impressions of sound to the brain. The process is quite intricate. 

The External Ear. — The external ear assists in collecting the 
waves of sound and these are conveyed through the external canal 
and reach the drum, which is thrown into vibration. 

By an arrangement of three connecting bones these vibrations are 
conveyed to the fluid in the labyrinth of the internal ear, and to the 
auditory nerve which transmits the impression to the brain, where 
these vibrations are perceived as sounds. 

The anatomy of the ear is generally divided into the external, the 
middle ear or tympanum and the internal ear. 

The external ear consists of that portion of the face known simply 
as the ear and the auditory canal. In man the muscles of the ear are 
rudimentary and permit of only very slight motion. The external 
ear consists of a layer of cartilage, which enables it to preserve its 
form, and various blood vessels and nerves which supply its nutrition. 



282 THE NEW MEDICAL WORLD. 

The Auditory Canal. — This extends from the external opening 
to the drum. It is nearly circular, about an inch long and somewhat 
crooked. This canal is lined with a thin skin containing sebaceous 
glands and a special set of glands, which secrete wax and prevent 
insects from entering the ear. 

The niddle Ear or Tympanum. — This consists of the drum, 
called the membrana tympani, and the cavity behind it, also the 
mastoid cells behind the ear and the Eustachian tube. The drum 
lies at the bottom of the auditory canal and separates it from the 
cavity behind it. It is a thin inelastic transparent membrane com- 
posed of three layers. The cavity behind the drum is called the 
cavity of the tympanum, and it is lined by mucous membrane which 
is a continuation of the lining of the pharynx and Eustachian tube. 

The Eustachian Tube and the Ossicles. — The Eustachian tube 
is about one and one-half inches in length, and extends from the 
throat to the cavity of the tympanum. It contains and conveys air 
which aids the process of hearing. There are three small bones, 
called the ossicles of the tympanum, stretched across the cavity of 
the tympanum. They connect the drum with the labyrinth, and 
serve to convey vibrations of sound from the drum across the cavity 
of the tympanum to the internal ear. They are joined to each other 
and to the walls of the tympanum by ligaments. Their names are 
the malleus (hammer), the incus (anvil), and the stapes (stirrup). 

The Internal Ear or Labyrinth. — This is the portion of the ear 
most essential to hearing, and to it the nerves of hearing, the aud- 
itory, are distributed. It is called the labyrinth on account of its 
winding, irregular shape. Its parts are the vestibule, semicircular 
canal and the cochlea. These parts are bony cavities lined with a 
thin membrane which secretes and contains fluid. Upon the walls 
of this membrane the nerves of hearing are distributed or spread out. 
These parts are so complex and so difficult to describe plainly and 
briefly that those who desire to pursue this subject are referred to 
special works upon the ear. 

II._DISEASES OF THE EAR. 

Deafness. — Persons having normal hearing ought to hear a watch 
tick twenty inches away. Deafness may be due to several causes, as 



THE NEW MEDICAL WORLD. 283 

obstruction from the secretion of hardened wax or other foreign body, 
and disease of the middle or internal ear. 

Deafness occurs, though rarely, as the 1 esult of such acute diseases 
as scarlet fever and cerebro-spinal meningitis. The acuteness of the 
hearing is tested by several methods, as the tick of a watch, the 
human voice, and the tuning fork. The voice test is considered as 
the most practical one for estimating the hearing power. 

The hearing is often affected by the general health or by previous 
illness. 

Deafness for various purposes is sometimes feigned. The clink of 
a coin dropped behind the pretender usually discloses the deception. 

Examination of the auditory canal is conducted by means of 
reflected light from a mirror, as in the examination of the eye. The 
mirror gathers the rays of light and reflects them into the ear. 

Impacted Wax or Cerumen. — This occurs frequently, and is due 
to an increased secretion of the glands, and is similar to a catarrhal 
condition of the mucous glands. It is sometimes secondary to other 
diseases. 

SYMPTOMS. 

These are a sense of fullness, sudden loss of hearing, sometimes 
pain, vertigo and ringing in the ears (tinnitus), due to the pressure 
of the hard mass upon the nerves. The hardened wax, owing to the 
drying action of the air, may resemble a stone, or it may be soft, and 
about the consistency of syrup. The accumulation of this material 
is so gradual that deafness does not come on until the canal is com- 
pletely obstructed, and this may occur suddenly from a jar that 
changes its position and closes up the canal. 

Sometimes there is other deep seated disease of the middle or 
internal ear, so that the removal of the wax will not cure the deaf- 
ness, but in many cases it is sufficient to remove it. 



TREATMENT. 

Use a soft rubber syringe and throw warm water into the canal to 
soften the mass. The addition to the water of a little glycerine and 
bicarbonate of soda renders it more efficient, or a few drops of the 



284 THE NEW MEDICAL WORLD. 

following may be dropped into the ear several times a day to soften 
the wax : 

1^ Bicarbonate of soda ten grains 

Glycerine one-half ounce 

Water one-half ounce 

Mix. The above prescription may be added to the wash and used 
.n the syringe in the proportion of one dram to an ounce of water. 

Foreign Bodies in the Ear. — Foreign bodies, as insects, beans, 
beads, orange or lemon seeds, buttons and the like are often lodged 
accidentally in the ears, especially of children. 

Insects may be dislodged by syringing out the ear with warm 
water, after which a little sweet oil may be dropped into the ear, or 
the warm water, before using, may have in it live or six drops of 
carbolic acid to the ounce of water. Beans, peas and other seeds 
after being lodged in the canal of the ear for some time swell and 
are quite difficult to rem'ove. To do this requires a practiced hand, 
and it is not possible to give sufficient instruction here to enable 
every one to perform such delicate work. 

Inflammation of the Ear. — This may be due to a cold or other 
obscure cause. 

SYMPTOMS. 

These are. a state of fullness and severe pain. If pus forms under 
the periosteum the pain is very severe, as in a felon. The child cries 
and cannot sleep. Relief comes with an incision down to the bone, 
or the more tedious rupture of the gathering into the auditory canal. 
The process may be hastened by hot fomentations and poultices. 
The pus which is discharged into the auditory canal should not be 
allowed to remain and dry on to the membranes as is often the case. 
The canal should be cleansed out with warm astringent solutions, as 
warm water containing boracic acid or pulverized alum, three or four 
grains to each ounce of water, or one or two grains of sulphate of 
zinc may be used to each ounce of warm water. 

TREATMENT. 

After cleansing out the auditory canal as above directed wipe it 
dry with absorbent cotton wound about a pine stick or probe, then 
dust into the ear a little pulverized boracic acid powder or iodoform. 



THE NEW MEDICAL WORLD. 285 

Powder blowers, made of glass or hard or soft rubber, are now 
made which are both cheap and efficient for blowing a little antiseptic 
powder into the ear and add much to the convenience and success 
of treating these diseases. 

Other inflammations, as abscesses, may occur in the vicinity of the 
auditory canal. They are often painful in the extreme, and cause 
temporary deafness by closing the canal. If the abscess points so 
that the place of its future rupture can be determined, instead of 
waiting for this event to occur it should be opened with the sharp 
point of a surgeon's bistoury, and afterward use the same treatment 
as recommended above for cleansing and healing. 

Polypi. — Polypi of the ear are exuberant granulations, the results 
of prolonged suppuration. They may occur in the auditory canal or 
in the cavity of the tympanum behind the ear drum. Wherever 
located their treatment is the same and must devise their destruction, 
either by the application of caustic, as chromic acid, or their removal 
by the wire snare. If the caustic is used it must be cautiously. To 
remove polypi by means of caustic or a snare is such a delicate opera- 
tion that only a skilled surgeon would care to attempt it. There are 
a few other rare -diseases of the auditory canal, as fungus growths, 
syphilitic ulcers and abnormal growths of bone (exostosis). The 
description and treatment, however, of such rare diseases is unnec- 
essary here, as considerable professional skill is required to treat 
them successfully. 

III.— DISEASES OF THE MIDDLE EAR. 

Rupture of the Drum. — This may be caused by the concussion 
from an explosion near at hand, blows on the side of the head, a 
wave striking the side of the head in surf bathing, violent vomiting 
or coughing, sneezing or blowing the nose, thrusting a hairpin or ear 
scoop carelesslv into the ear, or the unskillful use of instruments in 
the ear. The most frequent cause of rupture of the drum is the 
formation of pus in the middle ear. Rupture of the drum from 
injuries usually heals kindly, and without affecting the hearing. 
Rupture of the drum from concussion is more serious, and usually 
injury is done to other parts. 

Acute and Chronic Catarrh of the fliddle Ear, or Otitis 
riedia. — This is the most common of all the affections of the ear. 
It is known as ear ache, from the severe pain which accompanies it. 



286 THE NEW MEDICAL WORLD. 

The causes are numerous, as exposure to cold, or taking cold, espe- 
cially in the head, scarlet fever, diphtheria, measles, pneumonia, small 
pox and syphilis. The nasal douche, once so much employed for 
nasal catarrh, has fallen into disuse, because it often permitted water 
to pass up the Eustachian tube, into the cavity of the tympanum, and 
was a cause of this affection . 

SYMPTOMS. 

These are ringing in the ears, a sense of fullness, impaired hearing, 
swelling, causing the ear drum to bulge forward, catarrh of the 
pharynx, fever, and sometimes delirium. The common and uniform 
symptom is ear ache, a peculiarly severe pain . It is sometimes diffi- 
cult to tell what is the matter with a baby suffering from this affec- 
tion. The child cries, and manifests symptoms of extreme pain. 
The following will usually settle the difficulty. Pressure against the 
ear causes the child to squirm and cry. Dropping warm water into 
the ear produces a temporary quiet. 

TREATMENT. 

Specialists speak of leeches j3laced in front of the ear as of fore- 
most importance. Other remedies are warm water syringed into the 
ear for a few minutes at frequent intervals, steam, tobacco smoke, 
dry heat, as from the heart of a roasted onion, and laudanum or 
chloroform dropped into the ear. The following may be used : 

I£ Laudanum one dram 

Chloroform one dram 

Sweet oil one or two drams 

Mix and drop one, two or three drops into the ear as needed, or a 
piece of cotton wet in the mixture may be placed in the ear. Physi- 
cians often find it necessary to control the pain by the administration 
of an opiate, or the hypodermic injection of morphia. In order to 
prevent the disease from becoming chronic, prompt and efficient 
treatment should be employed. Unless simple means avail for curing 
the discharge the case should be intrusted to a medical adviser. 

Mild cases of this disease occur in persons who are in a run down, 
or scrofulous condition. In these cases the disease soon becomes 
chronic as the discharge continues in preference to healing. The 
chronic form of this affection is known as otitis media, otorrhcea, or 



THE NEW MEDICAL WORLD. 287 

There is no pain accompanying the chronic form of 
this affection. The discharge may be periodic, scanty, profuse, or 
purulent. Sometimes the whole canal is found to be full of dried 
pus. The drum head in some of the chronic cases is missing, having 
sloughed away. This stage of the disease is tedious, and requires 
patient treatment. It will be necessary to improve the patient's 
general condition and attend to his hygienic surroundings. 

Tonics are to be prescribed and everything attended to which will 
contribute to the more successful cure of this tedious affection. 
Cases have been known to continue for a life time which ought to 
have been cured. In the treatment of otorrhoea, cleanliness is of 
great importance. The ear should be washed out daily with some 
simple astringent solution, and then dusted with some antiseptic 
powder, as iodoform or boracic acid. The treatment must be varied 
to suit the conditions of each case and persisted in till a cure results. 
Polypi sometimes have their origin in this chronic suppuration which 
causes defects in the bone and its covering that become the site of 
these growths. 

Inflation of the Middle Ear. — This is beneficial in curing chronic 
affections, such as a running ear. The process is simple. It is known 
as Politzer's method. It consists of a rubber bulb and a tube with a 
hard rubber nozzle. The nozzle is placed in one nostril, the opposite 
nostril is pressed against the septum and closed, also the tissues are 
held close to the nozzle to prevent the entrance or exit of air. The 
patient holds water in his mouth and at a given signal is told to 
swallow, at the same time the bulb is compressed, this act inflates the 
Eustachian tube and the cavity of the middle ear. If the patient is 
an infant the inflation can be accomplished during the act of crying. 

Congenital Defects of the Ear. — The real cause of these defects 
is somewhat obscure. Children are sometimes born deaf, and all 
cases of congenital deafness are also mute. All those cases where 
the hearing is lost during the first years of life, before language and 
sounds are acquired, are mute. These are usually hopeless cases 
which resist treatment. 

IV.— MASTOID DISEASE. 

The mastoid process lies directly behind the external ear. The 
bone is honeycombed or made up of a large number of little open- 
ings or cells, separated from each other by a thin tissue of bone. 



288 THE NEW MEDICAL WORLD. 

When disease invades these cells the bone tissue breaks down or 
suppurates and the pus in seeking an outlet may advance to the brain. 
The cause of this disease is the extension of the inflammatory proc- 
ess from the middle ear. The treatment requires making an ex- 
ternal opening into the diseased bone for the exit of pus. The open- 
ing must be kept open and the healing process extend from below 
to the surface. Suppuration of the middle ear is sometimes followed 
by paralysis of the seventh cranial nerve. 



CHAPTER XV. 
THE NOSE AND ITS DISEASES. 



I. — Description of the Nose. II. — Acute Coryza, or Cold in 
the Head. III. — Ulcers in the Nasal Cavity. IV. — 
Other Minor Affections : 1, Warts ; 2, Polypi ; 3, Tu- 
mors, etc. V. — Hemorrhages from the Nose. VI. — 
Chronic Nasal Catarrh. VII. — Hay Fever, Rose Cold, 
or Summer Catarrh. 

I.— DESCRIPTION OF THE NOSE. 

THE nose is composed of bone, cartilage and other tissues, to- 
gether with the internal openings or the nasal fossa. 

The destruction of the cartilage and soft tissues gives to the skull 
a hideous appearance, as seen in a prepared skeleton. 

The nostrils are the openings of the nose, and are separated in the 
center by a partition of cartilage called the septum. 

The nose has a number of small muscles, situated just beneath the 
skin, which assist in the various expressions of the face. 

The mucous membrane lining the nasal cavities has a pink color, 
and is called the Schneiderian, after a celebrated anatomist. This 
lining membrane is abundantly supplied with glands which secrete 
sufficient mucous to keep it in a moist condition, but when these 
glands are inflamed they may secrete an enormous quantity. 

The nasal cavities are of irregular shape, and extend from the nos- 
trils to the larynx or throat. Through these the air passes to the 
lungs in the act of respiration. Their entrance is guarded by mois- 
ture and hairs in order to prevent noxious substances and particles of 
dust from entering the lungs. Moist air does not irritate the lungs, 
but dry air or dust would be very difficult to breathe. 

In passing through these long, irregular nasal cavities the air is 
moistened, strained, warmed, and especially fitted for respiration at 
all seasons of the year. 



290 THE NEW MEDICAL WORLD. 

The terminal branches of the olfactory nerves are spread out over 
the mucous membrane. The nerves recognize odors and convey the 
impression of them to the brain. 

The sense of smell is important ; it helps us to make choice of 
suitable foods and warns us of many dangers that lurk in the atmos- 
phere. The odor of food arouses the appetite, stimulates the glands 
of the mouth and stomach and thus not only strengthens the appetite 
but aids the process of digestion, while it contributes to the pleas- 
ure and happiness of our condition. 

A healthy or normal state of this membrane is essential. When it: 
is inflamed as in acute or chronic catarrh, not only is the sense of 
smell interfered with but the ability to enjoy the flavor of food is 
largely destined, while the natural process of breathing is obstructed. 

In speech, too, some of the sounds are nasal, their correct use is 
pleasing and their absence disagreeable. We hear it sometimes 
wrongfully observed that a person talks through the nose when the 
nasal cavities are obstructed and the nasal sounds cannot be em- 
ployed. The importance of the normal condition of the nasal cav- 
ities may be learned by listening to the attempts of a person to talk 
who has a cleft palate. 

II.— ACUTE CORYZA, OR COLD IN THE HEAD. 

This is of frequent occurrence for many persons are subject to a 
cold in the head from slight cause, such as sitting or sleeping in a 
draught of air, damping or wetting the feet, breathing dust or inhal- 
ing gases, or cooling off too quickly after getting heated. 

SYMPTOMS. 

The mucous membrane is at first congested or dry, there is a dis- 
position to sneeze, there is a stuffed feeling about the nose owing to 
the swelling or congestion of the mucous membrane. In the more 
severe cases there is headache, weariness, fever, hot and chilly sensa- 
tions, or perhaps severe frontal pain or neuralgia of the face. The 
dry stage is followed in about twenty-four hours with a profuse 
watery discharge from the eyes and nose and later on an abundant 
flow of mucous. The duration of the attack may be four or five days 
and the termination of it may result in the complete restoration of 
health or in a chronic catarrhal condition. 



THE NEW MEDICAL WORLD. 291 

TREATMENT. 

Those liable to colds should use especial care to guard against 
them. Living in too warm rooms or muffling the neck and face with 
extra coverings so as to favor perspiration invites rather than pre- 
vents attacks of this common affection. 

Sponging the head, neck and shoulders each morning with cold 
water and then rubbing the skin thoroughly dry with a coarse towel 
is good to toughen the external surfaces and prevent colds. 

When a cold is contracted a good sweat if taken early will some- 
times break it up. Sweating is favored by the hot foot bath and hot 
drinks as lemonade or herb tea. Wrap in warm blankets and go to 
bed. Perspiration is favored by a live-grain Dover's powder. A 
person who uses such treatment to break up a cold should re- 
main in the house several hours to prevent contracting a second cold 
which would most likely be more aggravated than if no remedies had 
been used. If there is some fever tincture of aconite in one drop 
doses may be taken hourly. 

When the discharge from the nose is profuse a solution of borax, 
alum or chlorate of potash may be used, snuffing it up the nose and 
also gargling the throat with it. It should be milder for the nose 
than for the throat. A teaspoonful of common salt to a pint of warm 
water is a good remedy to snuff up the nose. Medicated solutions 
may be syringed into the nostrils or sprayed with an atomizer. 

III.— ULCERS IN THE NASAL CAVITY. 

The most common cause of intractable ulcers in the nose is syphilis. 
The ulcerative process may advance till it reaches the cartilage or 
bone, and dead bone may be discharged. The odor of decaying bone 
is almost intolerable. Scrofula may cause ulceration in the nasal 
cavities. 

Foreign bodies in the nostrils, as a button, bean, kernel of corn, a 
pebble and such substances, will cause ulceration of the nose if 
allowed to remain in long enough. The treatment depends upon the 
cause of the ulceration, and must be adapted to each individual. 
(See syphilis and scrofula.) 

When dead bone exists its speedy removal is desirable. Foreign 
bodies should be at once removed. Iodoform in powder or ointment 
is one of the best applications that can be made to an ulcer which is 



292 



THE XEW MEDICAL WORLD. 



loath to heal. Aristol powder possesses similar efficiency and is 
preferable because it has a less disagreeable odor. 



IV.— OTHER AFFECTIONS. 

Growths in the nostrils are not uncommon ; they consist of warts, 
polypi, cancers and other tumors. 

Warts. — These should always be removed ; this can be done by 
applying a small amount of chromic acid carefully. (See warts.) 

Polypi obstruct the nose and affect the speech. They swell or 
become enlarged in damp weather and are otherwise disagreeable. 
They are soft, pear shaped, and usually hang by a small pedicle; 
they should be twisted off. Their removal is neither difficult nor 
very painful. 

Tumors. — For treatment of cancer of the nose see general article 
on cancers. The treatment of a cancerous growth is similar wherever 
placed. Hemorrhage of the nose is of frequent occurrence and has 
received sufficient attention in the special article upon this subject 
which follows. 

Surgical deformities of the nose cannot be treated in domestic 
practice, and are omitted intentionally. 



v.— HEMORRHAGE FROM THE NOSE. 

This occurs so often and is of such trifling importance in young 
]3ersons who make blood rapidly as to occasion but little concern. It 
may occur from a fall or slight injury and usually requires no inter- 
ference. 

In persons who are too full blooded it is frequently beneficial, re- 
lieves headache and promotes the general well being and should not 
be checked unless it continues too long and is too abundant. 

In the early stage of fevers when the veins are congested, the face 
flushed, the pulse rapid and bounding, a slight amount of nasal hem- 
orrhage is rarely productive of evil. 

When, however, it occurs in debilitated persons or is so severe as 
to threaten life it requires energetic measures. 



THE NEW MEDICAL WORLD. 293 

TREATMENT. 

Cold applied to the forehead and back of the neck will often 
check it. The feet may be placed in hot water ; this tends to relieve 
congestion of the blood vessels of the head while at the same time 
ice or cold lotions may be applied to the head and neck. Equal 
parts of vinegar and water make a convenient and cooling domestic 
lotion to apply to the head. It is excellent to relieve some kinds 
of headache. Pinch the nose close together with the thumb and 
finger and hold the head forward while the patient breathes through 
the mouth ; this is a method which will often succeed if continued 
till clots are formed to stop the hemorrhage. A solution of iron, 
(Monsel's solution) twenty drops in half a cupful of water, snuffed 
into the nostrils is a remedy of considerable efficiency. It may be 
used in an atomizer or as a nasal douche. In some instances, where 
life is threatened, plugging the nose in front and behind has been 
found to be an effective method. The operation requires consider- 
able professional skill. 

VI.— CHRONIC NASAL CATARRH. 

This is chronic inflammation of the mucous membrane which lines 
the nose and the cavities connected with it. These mucous linings 
become congested and the little glands which secrete mucous are 
unduly stimulated, so that the secretion becomes abundant. As the 
inflammatory action progresses the secretion becomes thicker and 
more disagreeable. The nasal passages are more or less obstructed. 

CAUSES. 

Nasal catarrh is caused chiefly by damp climates, sudden changes 
of temperature, exposure to draughts of air, repeated wetting or 
damping the feet, unsuitable clothing, changes in clothing before the 
weather becomes settled, leaving a warm room in a state of perspira- 
tion and going into the cold air, wearing thin shoes so that the feet 
become cold and chilled, and many other improprieties due to care- 
lessness or lack of the means of comfort. 

SYMPTOMS. 

The first symptom is a cold in the head. The nose feels stuffed by 
the swelling of the lining membrane, or perhaps by retained secre- 



294 THE NEW MEDICAL WORLD. 

tions, or both, so that the patient complains of being unable to 
breathe through the nose. There is frequent headache especially 
between the eyes. The mucous membrane is at first dry and irri- 
tated; there follows later a free discharge from the nose of thin 
mucous, and the handkerchief is a constant necessity. Soon the 
discharge becomes thicker and perhaps yellowish in color. Often a 
second cold is contracted before recovery has had time to take place, 
or there may be a succession of colds until recovery is retarded and 
a chronic catarrhal condition is established. The discharge becomes 
thick, greenish, and in time exceedingly disagreeable and offensive. 

While an acute attack reaches its height in a few days at most and 
tends to recovery in the course of one or two weeks the chronic form 
is persistent, and though better at times it may last for years, gradu- 
ally increasing in disagreeableness and severity. 

It is not so troublesome in summer but winter and spring awaken 
the disease to its fullest vigor. The chronic form is difficult to cure 
and when cured is unwilling to remain so for any considerable length 
of time. 

TREATMENT. 

When the disease has become chronic it is necessary first of all to 
cleanse the nasal passages for these are often ulcerated and in an un- 
healthy condition. For cleansing a solution of common salt and 
water snuffed up the nose till it can be tasted in the throat may be 
used. As the mucous lining is sensitive the solution must not be too 
strong. A teaspoonful of salt to a pint of water is about right. 

The following can be used in an atomizer or snuffed up from the 
hand. If strong enough to produce discomfort reduce with pure 
water. 

fy Sulphate of zinc four grains 

Cocaine three grains 

Carbolic acid four grains 

Rose water six ounces 
Mix and use three or four times a day. 

The following is highly recommended by excellent authority. 

P£ Tannin one dram 

Iodoform ten grains 



THE NEW MEDICAL WORLD. 295 

Mix and apply a small quantity of this powder by means of an in- 
sufflator to the parts after their thorough cleansing with salt and 
water solution. 

The following is excellent. Its strength can be varied as required 
by the addition of more benzoinol. 

^, Menthol one dram 

Cocaine ten grains 

Aristol twelve grains 

Benzoinol four ounces 

Mix and use in hand atomizer two or three times a day. 



VII.— HAY FEVER, ROSE COLD, OR SUMMER CATARRH. 

This is a catarrh which chiefly affects the mucous linings of the 
nose and air passages. It is likely to appear at about the same 
season each year. ' 

It is noticed that hay fever is more common among persons of a 
nervous temperament. 

Negroes are not troubled with it, neither does it occur among the 
natives of India. 



CAUSES. 

The two principal factors in the production of this disease are 
sensitive nerves and irritating substances floating in the atmosphere, 
as the pollen of certain plants and grasses, the pulverized dust in the 
streets and the dust of rooms. 

Some persons are seized by an attack in consequence of jDassing 
a hay field, or riding behind a load of hay, or entering a barn con- 
taining hay in the lofts. The fact that patients are more comfortable 
in damp, cloudy weather, or after a rain, seems to prove that the odor 
of the hay does not cause the trouble. 

The bloom of wheat, oats, rye, corn, barley, the rag weed and 
golden-rod excite the disease. The dust in furnace-heated houses 
and railroad cars, as well as many other irritating substances, may be 
regarded as helping to cause this disease. 



296 THE NEW MEDICAL WOULD. 

SYMPTOMS. 

It usually comes on with sneezing. If you look towards the light 
or sunshine an irresistible impulse to sneeze seizes you, but sneezing 
brings no relief. You continue to sneeze in spite of every effort to 
refrain ; there is an increase of the secretions of the mucous tract, 
and the eyes and nose overflow. 

You feel an itching in the throat which extends toward the ear, 
but you cannot reach it, and there is a stuffy, obstructed condition of 
the nose, which compels you to breathe through the mouth. Some 
persons suffer from an itching of the skin, especially about the nose, 
pain in the head, slight fever and loss of appetite, also a tickling sen- 
sation in the upper part of the windpipe. The mucous linings of the 
nose and throat are congested and swollen. There is cough and 
more or less catarrh. The patient feels extremely uncomfortable and 
unwillingly yields to a wretchedness which renders life burdensome. 

The discomfort seems greatly out of proportion to the disease. It 
is persistent. You feel relieved perhaps for a time but your peace is 
brief. This condition may continue for days and even weeks. Each 
year the attack tends to greater severity and discomfort. The dis- 
ease of itself is never fatal, simply annoying. Sometimes it extends 
downward to the lungs and develops an asthmatic condition. 



TREATMENT. 

The most certain treatment for those who can afford it is a change 
to regions where it does not exist. Sea voyages are beneficial and 
curative, but all catarrhal troubles are liable to recur. 

The syrup of hydriodic acid is an efficient remedy. The dose is 
one teaspoonful in water before each meal. This syrup when fresh 
and suitable for use is colorless. 

When the secretion of thin, watery mucous is very abundant the 
sulphate of atropia affords marked relief. A tablet containing y^-g- 
of a grain once or twice a day is a suitable dose for an adult. 

The inhalation of menthol affords some relief. It does not cure ; 
it is simply palliative. 

Tincture of iodine sufficiently reduced with water may be used as 
a spray for the nasal passages with a hand atomizer. 



THE NEW MEDICAL WORLD. 'J97 

The following prescription is one of great value and affords much 
relief : 

I£ Sulphate of zinc six grains 

Carbolic acid ten grains 

Cocaine six grains 

Glycerine two ounces 

Rose water four ounces 

Mix. Use in atomizer by throwing it up the nose freely and repeat 
with the return of sneezing or other symptoms. 



CHAPTER XVI. 
THE MOUTH AND ITS APPENDAGES, 



I. — Description of the Mouth an Its Appendages : 1, the 
Mouth ; 2, the Upper and Lower Jaw ; 3, the Mucous 
Membrane ; 4, the Lips ; 5, the Cheeks ; 6, the Glands ; 
7, the Tongue ; 8, the Gums ; 9, the Antrum ; 10, the Pal- 
ate ; 11, the Teeth. II. — Diseases op the Mouth, 
Tongue and Vicinity : 1, Alveolar Abscess, or Gum 
Boil ; 2, Catarrhal Stomatitis ; 3, Canker, or Aphthous 
Sore Mouth ; 4, Gangrenous Stomatitis, or Cancrum 
Oris ; 5, Toxic Stomatitis ; 6, Other Minor or Rare Af- 
fections — a, Calculus of the Ducts ; #, Salivary Fis- 
tula ; c, Growths ; c?, Hare Lip ; e, Hypertrophy of the 
Lips ; 7, Diseases of the Tongue — a, Tongue Tie ; b, 
Enlargement of the Tongue, or Hypertrophy ; c, In- 
flammation of the Tongue, or Glossitis. 

L— DESCRIPTION OF THE MOUTH AND ITS AP- 
PENDAGES. 

THE MOUTH. — The mouth is a roomy cavity adapted to various 
purposes, as the reception, mastication and preparation of food 
for the stomach, the origin and insertion of powerful muscles which 
open and close the jaws, muscles which control speech and some 
of the muscles of expression. 

The mouth takes the place of the nostrils when they are ob- 
structed and admits the air on its way to the lungs. It provides 
lodgement for the nerves of taste, and is supplied with a corre- 
spondingly large number of associate organs as the tongue, gums, 
teeth, lips, palate and glands. 

The Upper and Lower Jaw. — The mouth is surrounded by a 
bony framework which protects it from injury, gives insertion to 
powerful muscles used in chewing the food, affords firm ridges for 



THE NEW MEDICAL WORLD. 299 

enclosing the roots of the teeth and protection for the arteries and 
nerves which are abundantly supplied to these and neighboring 
organs. 

The ilucous flembrane. — The whole cavity of the mouth is 
covered over with a thick layer of mucous membrane which is much 
less sensitive than that about the eye or which lines the nose. Its 
beginning is seen along the border of the lips where the skin and 
mucous membrane unite. It extends throughout the whole alimen- 
tary canal. The lips are composed chiefly of muscles and muscular 
fibres, which control the expressions of the lower portion of the face. 
These, with the other muscles of the eye and face, are trained and 
developed by the contortionist to a remarkable degree. 

The Lips. — The lips guard the entrance to the mouth. They are 
well supplied with delicate nerves of sensation and it is probably 
owing to this fact that they are the organs chosen to express affec- 
tion. They also contribute their part to the complex process of ar- 
ticulation. 

The Cheeks. — The cheeks cover over the sides of the mouth and 
contain muscles which help to open and close the lower jaw. 

The Glands. — In front and below the lower half of the external 
ear lies a large salivary gland, the parotid, and this is the gland which 
is inflamed in mumps. Its secretions are poured out into the mouth 
through a duct two and one-half inches long (Steno's duct). This 
duct opens upon the inside of the cheek opposite the second molar 
teeth. The duct is about the size of a crow's quill. It sometimes 
becomes obstructed, which is the primary cause of a salivary fistula. 
The parotid gland is stimulated to action by the movement of the 
lower jaw in eating and pours out a large amount of fluid to moisten 
the food. The mucous membrane of the mouth is supplied with nu- 
merous other glands as the buccal, which also supply lubricating ma- 
terial. There are other large glands as the sub- maxillary, in front of 
the angle of the lower jaw; and the sub-lingual, under the for- 
ward portion of the tongue. These glands open by means of tubes 
or ducts under the tongue ; they secrete a large amount of fluid to 
keep the mouth moist and to aid in the mastication of food. 

The Tongue. — The tongue lies in a depression at the bottom of 
the oral cavity between the two sides of the lower jaw. Its free end 
extends forward and rests against the gums and teeth. With very 



300 THE NEW MEDICAL WORLD. 

slight exertion it can be protruded from the mouth or moved from 
side to side. It becomes thicker, wider and larger as it approaches 
the roots in the throat or back part of the mouth, where it is held in 
place by a number of muscles attached to the hyoid bone. The 
tongue is the organ of taste. It is supplied by a special nerve, the 
gustatory, the terminal ends of which are gathered up into little ele- 
vations, or papillae, which can be seen as little red, pointed elevations 
upon its upper surface. On the back part of the tongue there are a 
number of these papillae which are much larger than the rest, arranged 
in the shape of a harrow, with the point directed backward. The 
tongue is composed of muscular fibres which are liberally supplied 
with blood vessels and nerves. The muscular arrangement divides 
the tongue in the middle into two separate halves, with a fibrous sep- 
tum in the center binding them together. The tongue assists in mov- 
ing the food about in the mouth and rolling it up into a bolus to swal- 
low. It is an important organ of speech. 

The Gums. — The gums are ridges of firm tissue overlying a bent 
framework and the alveolar process which is covered in by them. 
The gums, with the alveolar process, surround the teeth and hold them 
in position, affording them a firm and permanent lodgement, so that 
the biting and chewing of hard substances is easily accomplished and 
does not loosen them. 

The Antrum. — Within the bone on each side of the upper jaw is 
contained a large opening called the antrum. It extends from under 
the floor of the orbits to the roots of the molar teeth. This cavity is 
of interest because it is sometimes the seat of a painful abscess. It 
is nearly or quite penetrated by the roots of the molar teeth and the 
irritation of their fangs is probably the usual cause of the abscess 
which sometimes forms here. The natural outlet of this cavity or an- 
trum is large enough to admit the end of a probe and terminates in 
the nasal passage. 

The Palate. — The roof of the mouth is known as the hard palate 
until it reaches back to that portion which has no bone above it and 
at this point the soft palate begins. The soft palate terminates be- 
hind in a central, cone-shaped projection, with the apex pointing 
downward into the throat ; this is called the uvula. 

The uvula sometimes becomes elongated or hypertrophied and 
causes so much irritation that astringents have to be applied to it to 



THE NEW MEDICAL WORLD. 301 

shrink it up or the bottom portion of it has to be snipped off with a 
pair of scissors or some similar method. 

The Teeth. — These are important and fully considered elsewhere 
because of their value in the reduction and preparation of food 
for the stomach. 

II.— DISEASES OF THE MOUTH, TONGUE AND 

VICINITY. 

The mouth and its appendages are subject to a great variety of 
diseases, from the slightest to those of the most serious consequence. 

Alveolar Abscess or Gum Boil — This is a common affection, and 
often occurs even when the teeth are Avell cared for. 

SYMPTOMS. 

Soreness of a tooth to the touch, or on closing the jaw, is usually 
the first thing noticed. This sometimes continues for a day or so 
when pain is established, which continues in an increasing manner for 
four or live days, when it begins to decline. The face swells and at 
length pus is discharged through the gum at the point where the 
swelling was greatest. Repeated attacks are likely to occur. 

TREATMENT. 

The common practice of poulticing the face should be discouraged. 
It may ease pain but is likely to increase the damage to the sur- 
rounding tissues. Cold applications or menthol liniment may be 
used until a dentist can be consulted. 

Catarrhal Stomatitis — When the mucous membrane lining the 
mouth is inflamed the affection is known as stomatitis. There are 
several varieties of this disease as catarrhal, aphthous, parasitic, 
ulcerous, gangrenous, toxic and mercurial. Catarrhal stomatitis is 
simply an inflamed condition of the oral cavity, which may be due to 
a great variety of causes, as too hot drinks, the abuse of tobacco 
or stimulants, acrid substances, irritating dust, gases, smoke and 
steam. It may be difficult to ascertain the cause. In the newly 
born a form of catarrhal sore mouth is common, and this is some- 
times called thrush. It may be caused by nursing an exhausted 
breast, or perhaps by protracted crying. 



302 THE NEW MEDICAL WORLD. 

Canker or Aphthous Sore flouth. — Canker sore mouth prevails 
chiefly in warm weather. It occurs in pale, delicate children or 
those of a scrofulous condition, but sometimes in connection with 
neglected or decayed teeth. It appears within the mouth, either 
upon the inside of the cheek, upon the gums or tongue, as a small 
circular ulcer, having irregular edges and a whitish appearance. 
Often several of these ulcers unite and form a large irregular 
ulcerated surface, and in such cases the disease is confluent. Canker 
may occur in children of all ages or in adults. 



SYMPTOMS. 

The constitutional disturbances are often mild and consist in 
a coated tongue with indigestion. In severe cases there is occa- 
sionally some fever and loss of appetite. These little ulcers are 
exceedingly sensitive, disagreeable and painful, accompanied with 
a constant smarting or burning sensation. Eating, if possible, is 
painful. In a few days they lose their disagreeableness and heal 
kindly. 

TREATMENT. 

Very simple treatment avails, as a mild cathartic dose of castor oil 
or citrate of magnesia when the bowels are constipated. A solution 
of borax, alum or chlorate of potash may be used with benefit as 
a mouth wash. Other vegetable washes may be made of hydrastis, 
gold thread, witch-hazel or sage tea. The ulcers may be touched if 
painful with a solution of cocaine. Cold milk is soothing and makes 
an excellent article of diet in these cases. Tonics and digestive aids 
are often beneficial to these patients. 

Gangrenous Stomatitis, or Cancrum Oris. — This is a disease 
of debilitated and underfed children. It is a rare and dangerous dis- 
ease and by some regarded as contagious. It occurs most frequently 
in public institutions after measles, scarlatina, whoojjing cough, ma- 
laria and pneumonia. The disease spreads by ulceration and slough- 
ing which sometimes causes hemorrhage. The chief characteristic of 
this disease is ulceration, beginning just inside the mouth and extend- 
ing to the cheek, and accompanied by gangrene or death of the part. 
The real cause is not generally known. 



THE NEW MEDICAL WORLD. 303 

SYMPTOMS. 

Amons; the symptoms there may be rapid pulse, rapid swelling of 
the mouth and cheek, a foul odor and sometimes delirium. 

TREATMENT. 

Local applications should be made to arrest the progress of the dis 
ease and the most efficient are caustics, as muriatic acid or nitrate of 
silver. Only the unhealthy tissue should be destroyed and next the 
parts should be dressed with antiseptic and healing lotions, as car- 
bolic acid solution. Nutritious food and supporting tonics are de- 
manded. 

Toxic Stomatitis — This is due to the action of caustic drugs 
taken intentionally or accidentally. It should be treated with emol- 
lient and soothing lotions as the following : 

3 Cocaine six grains 

Carbolic acid ten grains 

Glycerine one-half ounce 

Syrup of acacia one ounce 

Fluid ext. hydrastis one-half ounce 

Rose water one ounce 

Mix and use as a mouth wash. Dilute with water if necessary. 
The diet should consist of milk, raw or slightly cooked eggs and al- 
buminous foods. 

Other Minor or Rare Affections, (a.) Calculus of the Ducts. 
— There are a few other rare affections of these parts which belong 
more to the domain of surgery than medicine. A calculus some- 
times forms in one of the ducts leading from the glands under 
the tongue. It can be easily removed. 

(b.) Salivary Fistula. — The duct of the parotid gland may 
become obstructed and a fistulous track open for the discharge of the 
saliva. This occurs sometimes upon the outside of the cheek instead 
of within the mouth. This trouble requires early attention and 
surgical interference. 

(c.) Growths. — Tumors or cancerous growths about the mouth or 
tongue require prompt and energetic treatment, and hence should be 
submitted without delay to the experience and judgment of the 
skillful. 



304 THE NEW MEDICAL WORLD. 

(d.) Hare Lip. — There is sometimes a congenital opening in the 
center of the upper lip ; it may extend backward through the roof of 
the mouth or hard palate. This failure of nature or deformity can 
only be remedied by a surgical operation. 

(e.) Hypertrophy of the Lips. — The glands of the lips are liable 
to enlarge in scrofulous children. This enlargement is sometimes so 
extensive as to suggest an idiotic appearance. Not only the glands 
but the surrounding tissues become hypertrophied or swollen. 

Attention to the general health may suffice to remedy this unsightly 
thickening of the lips, but if not, it is advisable to remove a Y-shaped 
piece of the redundant tissue, using sufficient caution to prevent 
future disfiguration. 

Diseases of the Tongue, (a.) Tongue Tie. — This is caused by 
a thin band which binds down the tip of the tongue so that it cannot 
be extended. It interferes with nursing on the part of an infant and 
later on with speech. It is easily remedied by cutting through this 
thin band with a blunt pair of scissors. 

When the tongue is wounded it tends to bleed very freely. Wounds 
of the tongue are dressed by drawing the separated portions together 
with stitches. They unite readily owing to an abundant vascular 
supply. 

( b.) Enlargement of the Tongue, or Hypertrophy . — This is a 
rare and troublesome affection in which the tongue hangs outside the 
mouth. Medicines are of little or no avail. A portion of the tongue 
usually has to be removed and this operation yields a satisfactory re- 
sult. 

(c.) Inflammation of the Tongue, or Glossitis. — This is not a 
very frequent affection. It may be superficial or involve the whole 
substance of the tongue. The symptoms appear suddenly and increase 
rapidly. They are heat, swelling, stiffness of the tongue and im- 
paired mobility. The tongue becomes dry and heavily coated and it 
may swell to an enormous size so as to fill the whole oral cavity. 
The symptoms are sometimes preceded by chills followed by fever, 
headache and pains in the neck. Sometimes the disease is so aggra- 
vated as to threaten suffocation. In such cases speech is difficult and 
eating is impossible. The glands, lingual and sub-maxillary, are also 
swollen and give pain. Sleep and respiration are disturbed and the 
expression is anxious. The pulse is quick and the temperature high. 



THE NEW MEDICAL WORLD. 3Q5 

CAUSES. 

The causes are various. It may be due to some injury or it may 
result from decayed teeth or from debilitating diseases. It may 
originate from syphilis, the excessive use of mercury, and the use 
of toxic or poisonous substances. It prevailed in this country about 
the year 1845, under the name of black tongue, and appeared to 
be epidemic. Many cases were fatal within two or three days. 

TREATMENT. 

Warm washes of borax or alum, five grains to the ounce of water, 
or tannin dissolved in glycerine may be sufficient for the sui^erficial 
variety; but when the entire tissues of the tongue are involved other 
remedies are required. The bowels should be moved freely. 
Tincture of aconite in one drop doses, associated or alternated hourly 
with tartar emetic in doses of one-fortieth of a grain will prove 
valuable treatment. If relief does not ensue it is customary to make 
deep incisions in the tongue. Free hemorrhage follows these in- 
cisions which relieve the inflammation. If the breath is fetid a 
mouth wash containing permanganate of potash, two or three grains 
to the ounce of water, should be used or a carbolic acid solution 
of proper strength. 

A serious case of glossitis should be given into the hands of a 
competent physician, who will treat it as the symptoms demand. 



CHAPTER XVII. 

THE THROAT, LARYNX AND THEIR 

DISEASES. 



I. — Description of the Throat and Larynx : 1, the Throat; 2, 
the Larynx. II. — Affections of the Throat : 1, Getting 
Choked ; 2, Taking Cold. III. — Acute Sore Throat, or 
Laryngitis. IV. — Chronic Sore Throat, or Clergyman's 
Sore Throat. V. — Loss of Voice, or Aphonia. VI. — 
Quinsy Sore Throat, or Tonsilitis. 

I.— DESCRIPTION OF THE THROAT AND LARYNX. 

THE THROAT.— That portion of the oral cavity back of the 
mouth and behind the roots of the tongue is known as the 
throat. It is bounded in front by the uvula and base of the tongue, 
and behind by a lining of mucous membrane known as the walls 
•of the pharynx. It extends downward to the opening into the 
trachea, called the larynx ; and the opening into the oesophagus, 
sometimes called the gullet. The portions of the throat visible with- 
out a mirror are the tonsils and pharynx. 

The Larynx. — The opening into the windpipe is called the 
larynx. It lies in front of the oesophagus. 

The larynx has a cartilaginous structure which may be seen and 
felt in the front part of the neck. It is known as the Adam's apple. 
It moves up and down in the act of swallowing. Its upper extrem- 
ity forms a cavity or box for the vocal cords, which are stretched 
across it. It is the organ of voice. On account of its rigid structure 
it remains open constantly, while the sides of the oesophagus fall 
together, except when food is passing into the stomach. 

II.— AFFECTIONS OF THE THROAT. 

Getting Choked. — If one talks or laughs while swallowing there 
is danger from bits of food or drink being drawn into the larynx, 



THE NEW MEDICAL WORLD. 307 

which will occasion energetic coughing for its removal. Some- 
times a piece of meat or other food is drawn into the larynx which is 
laro-e enough to completely obstruct it and prevent the entrance 
of air. This is the condition known as being choked, and unless 
relief is speedy death soon ensues. Fortunately this accident is 
so well guarded against by the epiglottis that it does not occur 
frequently. 

Taking Cold. — Colds from exposure and changes of temperature 
are very liable to attack the throat, producing inflammation and sore- 
ness of the mucous membrane and tonsils. Not only are climatic 
changes liable to affect the throat unfavorably, but polluted air from 
close sleeping rooms, sewer gas and bad sanitary conditions in or 
about the house. Persons who live in hot and badly ventilated 
rooms are more subject to colds and throat diseases than those who 
give proper attention to their surroundings. 

When going out from a warm room it is advisable to breathe only 
through the nose in order to warm and moisten the cold air before it 
reaches the lungs. From the liability of the mucous membrane of 
the nose to become congested and the nostrils to become obstructed, 
ample provision is made for the passage of air to the lungs by way of 
the mouth. 

IIL_ACITTE SORE THROAT, OR LARYNGITIS. 

The term sore throat has reference to an inflammation of a greater 
or less degree of one or more of the structures or neighboring; tissues 
of the throat. It may extend to the larynx or be confined to the ton- 
sils, palate or the pharynx. Sore throat accompanies many diseases 
as scarlet fever, diphtheria, erysipelas and small pox. It is frequent 
in the last stages of consumption and in the early stages of syphilis. 
It may be caused, by accident as when hot or corrosive fluids are swal- 
lowed. It is sometimes occasioned by the inhalation of poisonous 
gases or breathing air containing dust and other impurities. It may 
result from the excessive use of tobacco or alcoholic liquors. The 
most common cause of sore throat, however, is the sudden taking of a 
cold from exposure, especially when the body is overheated. 

SYMPTOMS. 

The symptoms are pain, irritation, redness, swelling, difficult breath- 
ing, pain in swallowing, hoarseness and cough. At first the throat 



308 THE NEW MEDICAL WORLD. 

may seem dry but afterwards there is an accumulation of tough mu- 
cous and sometimes there is complete loss of the voice. The symp- 
toms may be slight and occasion but little attention or they may be- 
so severe as to interfere with all labor, causing great distress and con- 
cern. The symptoms will depend upon the severity of the attack, 
the amount of tissue i lvolved and the progress and extent of the in- 
flammation. 

TREATMENT. 

For a mild case rest, protection from exposure and a spare diet are 
appropriate. In the early stages it is proper to soak the feet in hot 
mustard water. Take a bowl of hot drink, go to bed and wrap up 
warmly. A flannel wet in camphor liniment may be placed around 
the neck. If there is severe irritation and inflammation of the throat 
the following gargle will help to allay it and afford relief. 

3 Cocaine ten grains 

Carbolic acid twenty grains 

Chlorate of potash two drams 

Glycerine one ounce 

Rose water three ounces 

Mix. Gargle a teaspoonful every hour. 

Tartar emetic given in doses of one-sixtieth of a grain every hour 
promotes the activity of the secreting glands, and is an excellent 
remedy in these cases. 

IV.— CHRONIC SORE THROAT, OR CLERGYMAN'S 

SORE THROAT. 

This disease may result from a succession of acute attacks which, 
leave the throat in a debilitated and inflamed condition. It may last 
for years, involving usually both the pharynx and larynx. It is 
common to those persons who use the voice constantly, as clergymen,, 
singers, teachers, actors, auctioneers and many others. 

SYMPTOMS. 

The blood vessels are congested and the throat is inflamed and 
more red than natural. There is irritation in the throat and a con- 
stant effort to relieve it by hawking. Sometimes there is very 
marked hoarseness when the larynx is involved. More or less 
catarrh attends this affection. 



THE NEW MEDICAL WoKLl). o(J9 

TREATMENT. 

The treatment requires rest of the voice and the use of astringents 
to relieve the congestion. Gargles of alum, chlorate of potash and 
similar remedies are beneficial. A hand atomizer throws the finely 
divided spray with force and causes the remedies to reach the parts 
better than when gargled. 

The general health must be looked after and the voice used 
cautiously. Local applications of the tincture of iodine and glycerine, 
equal parts, or a solution of nitrate of silver are often required to 
effect a cure. 

V.— LOSS OF VOICE, OR APHONIA. 

This may occur from one or several causes, as hysteria or other 
nervous disorders, from growths which press upon and paralyze the 
nerves, ulceration, and from laryngitis, either acute or chronic. 

Before much successful treatment can be instituted it is necessary 
to ascertain the cause of the affection. Tonics are often necessary as 
quinine, iron and strychnia, thus : 

I£ Quinine thirty grains 

Reduced iron twenty grains 

Strychnia one-third of a grain 

Mix. Make into twenty pills or tablets. Dose, one three times a 
day. 

Electricity may be tried in paralysis of the vocal cords. The in- 
halation of medical sprays from a steam atomizer is a rational method 
of treatment. Solutions of alum or borax are suitable for such a use. 
Atropia given in doses of y-J^ of a grain usually gives satisfactory 
results. 

VI.— QUINSY SORE THROAT, OR TONSILITIS. 

This is an acute and painful disease, characterized by a rapid 
inflammation of one or both of the tonsils, accompanied by restless- 
ness, fever and much distress. 

The cause of this disease is often thought to be a scrofulous condi- 
tion of the system. Persons who have large tonsils are liable to 
have repeated attacks. After middle life liability to attacks of this 
disease diminishes. The poison of sewer gas and defective drainage 
or unwholesome surroundings are favorable to the development 
of tonsilitis. 



310 THE NEW MEDICAL WOULD. 

SYMPTOMS. 

These are headache, chilly sensations, followed by pain in the 
limbs, restlessness with fever and high temperature, sometimes reach- 
ing 104 degrees, rapid pulse, coated tongue, fetid breath, soreness in 
the tonsils and difficulty in swallowing, which may so increase as to 
render the act almost impossible. There is an increase of the secre- 
tions of the salivary glands, which are viscid and expectorated with 
difficulty. Sometimes the pain in attempting to swallow even fluids 
is very severe, extending into the ear, and the fluid may be 
forced back through the nose. Sometimes the tonsilar glands 
become so enlarged as to push clear across and fill the throat, or 
if both are inflamed they crowd against each other in the center. 
The symptoms are proportionate to the severity of the attack. 
Tonsilitis is common during epidemics of measles, scarlet fever 
and diphtheria, and often a membrane forms which renders the early 
diagnosis confusing. The disease may last from five to ten days. 

Sometimes the swelling gradually subsides and full recovery ensues 
in a short time or the disease may advance to suppuration. When 
the latter takes place the symptoms are augmented in severity and 
the temperature and fever correspond to this septic condition. The 
patient is very restless, tossing and unable to sleep ; the distress is 
very great and increases until the abscess is opened or bursts, when 
a feeling of relief quickly follows. The same person often experi- 
ences repeated attacks of this disease at intervals of a few months or 
one or two years. 

TREATMENT. 

Sometimes it may be aborted by the early application of turpentine 
to the throat externally. The tincture of iodine may be carefully 
painted over the inflamed tonsils internally, or a solution contain- 
ing twenty grains of nitrate of silver in an ounce of water. These 
remedies should be used early in order to render the attack abortive. 

A full dose of quinine taken early has been known to abort this 
distressing disease. The chlorine mixture as recommended in diph- 
theria is an appropriate and excellent gargle. 

When the process continues or the inflammation has become well 
established before the use of the abortive treatment, other remedies 
will be required, such as aconite in drop doses for the fever and a 
Dover's powder for the pain. 



THE NEW MEDICAL WORLD. 311 

The following gargle is highly recommended by good authority. 

I£ Tinct. guiac ammoniated one ounce 

Tinct. cinchona comp. one ounce 

Clarified honey three ounces 

Chlorate of potash (saturated solution) 

q. s. for a one pint mixture 

This is to be gargled freely every hour or half hourandateaspoon- 
ful taken internally, by an adult, every two hours. 

When the case goes on to suppuration hot fomentations will aid the 
process and afford some relief ; also inhalations of hot steam from 
Avater, hops or vinegar and water. When the abscess is ripe the 
patient may be quickly relieved by lancing the suppurating tonsil, and 
this may save hours of suffering. 

The bodily strength should be maintained by the use of nourishing 
broths. Stimulants are rarely needed. 

Persons subject to attacks of tonsilitis should avoid exposure 
as Avet clothing, wet feet and currents of air when heated. They 
should be suitably protected from the changes of temperature and 
give attention to any early symptoms of the disease, when the 
methods already suggested will usually succeed in warding it off. 



CHAPTER XVIII. 
THE TRACHEA, OR WINDPIPE AND LUNGS. 



1. — The Trachea. II. — the Lungs. III. — Asthma. IV. — 
Bronchitis. V. — Capillary Bronchitis. VI. — Pleurisy. 
VIL— Pneumonia. VIII. — Consumption. IX. — the Pre- 
vention of Consumption. 

L— THE TRACHEA. 

THE trachea is a hollow tube made up of cartilaginous rings and 
lined on the inside with mucous membrane. It extends down- 
ward from the larynx toward the lungs, and in the adult is about 
four and one-half inches in length and about one inch in diameter. 
It is situated in the front and middle of the neck and just behind it 
lies the oesophagus. The cartilaginous structure of the trachea keeps 
it open permanently as it is in constant use. The lower end of the 
trachea divides into the right and left bronchi, one of which enters 
the right and the other the left lung ; farther on it divides up like 
the limbs of a branching tree in order to reach and carry the air to 
every portion of the lungs. The trachea is of unusual interest be- 
cause a sudden cold, congestion or inflammation of the mucous lin- 
ing is often attended with great danger to life. In an infant or 
young child the trachea is small and even a slight obstruction 
may threaten serious results. It is sometimes necessary when the 
trachea is nearly obstructed and the respiration is greatly hindered to 
make an opening, tracheotomy, into the windpipe and insert a tube, to 
facilitate the passage of air into the lungs. This delicate operation 
has sometimes saved a life when hope had well nigh fled. 

This operation may also be required for the removal of a foreign 
body from the trachea as a shoe button or a peanut, which has been 
accidentally drawn into the larynx and lodged at the bifurcation. 
Through this opening the foreign body may be extracted. Trache- 
otomy requires great skill and much attention to details to secure suc- 
cess. 



THE NEW MEDICAL WOULD. 



313 



II.— THE LUNGS. 

The lungs are two cone-shaped organs situated, one on each side 
of the chest, and held in position by ligaments known as the roots of 
the lungs. The right lung is larger than the left. They are divided 
by natural fissures into lobes, the right lung possessing three, while 
the left has only two. The outside is covered by a thin, transparent 
membrane, which is a continuation of the pleura or covering of the 
inside of the chest walls. 




The larynx, trachea, bronchial tubes, c utline and internal structure of the lungs : a, 
thyroid cartilage ; b, cricoid cartilage ; c, first cartilage of the trachea ; d, bifurcation of 
the trachea ; e, f , right and left bronchus ; g, bronchial tube. 



The lung substance is light, porous, spongy and elastic, floats 
In water and contains air in its spaces. The lungs contain a vast 
number of air cells which are the termination of the bronchial tubes. 
The renewal of air in the lungs is accomplished by the act of respira- 
tion which takes place in a normal condition about eighteen times a 
minute. A large amount of oxygen is consumed and the air is 
rapidly vitiated by the act of respiration, hence the importance of 
ventilation. 



314 T FIE NEW MEDICAL WOKLD. 

III.— ASTHMA. 

Asthma is a spasmodic contraction of the circular muscular 
fibers of the trachea and bronchi. It is due particularly to a 
disturbance or irritation of the nerve filaments in the air passages, 
which produces the spasmodic condition. It renders the breathing 
labored and difficult for a varied length of time. Attacks may oc- 
cur at intervals near or remote. The exciting causes which produce 
asthma are various, as indigestion, the inhalation of dust, certain odors 
and the pollen of plants. Exposure to cold and dampness favors an 
attack. 

SYMPTOMS. 

It may come on suddenly or after catarrh and bronchial irritations. 
The breathing is labored and attended by wheezing ; the expression 
is anxious, and so great is the effort to obtain air that the face is 
sometimes bathed in perspiration. There is a peculiar feeling of 
tightness about the chest. In a characteristic case the patient sits 
and elevates his shoulders by resting his hands upon the knees, or he 
stands, leaning over a chair or some other article with the shoulders 
raised, the back rounded and sweating profusely. There is a dusky 
hue about the face, the pulse is small and quick and the extremities 
chilly. This disease is in no sense an inflammation. It is simply a 
nervous affection. There is no inflammation in the lung or air pas- 
sages and when the paroxysm of asthma lets up the patient is im- 
mediately relieved and goes about apparently as well as ever. 



TREATMENT. 

Relief may be afforded by dropping a little nitrite of amyl upon a 
handkerchief and inhaling it, but relief from this source is uncertain- 
The inhalation of a little chloroform will modify or break up an at- 
tack but such a remedy is unsuitable to use except in severe cases and 
with the utmost caution. The most efficient remedy known to give 
relief is the fourth of a grain of morphia hypodermically adminis- 
tered, or twenty grains of chloral dissolved in sweetened water and 



THE NEW MEDICAL WORLD. 315 

taken by the stomach. The two remedies may be combined to ad- 
vantage as in the following prescription : 

r> Morphia one grain 

Chloral four scruples 

Syrup of orange peel half an ounce 

Cinnamon water half an ounce 

Mix. Dose a teaspoonful, and repeat in two or four hours if 
needed. 

The tincture of lobelia is a valuable remedy, given in ten drop 
doses every fifteen minutes until nausea is produced. The following 
prescription is a good one. The author cannot recall a case that 
it has not either relieved or permanently benefited. 

r> Iodide of potash two drams 

Extract grindelia two drams 

Extract elecampane half an ounce 

Tinct. of lobejia half an ounce 

Syr. senega one and one-half ounces 

Wintergreen water q. s. to make four ounces 

Mix. Dose a dessert spoonful as needed for an adult. 

The following is said to afford relief : 

Pulv. lobelia leaves two drams 

Pulv. stramonium leaves two drams 

Pulv. belladonna leaves two drams 

Nitrate of potash three drams 

Mix. Put some of this into a clean clay pipe and smoke for ten or 
fifteen minutes at intervals during an attack. 



IV.— BRONCHITIS. 

This is an acute inflammation of the bronchi or the mucous lining 
of the air passages. It may be local and involve only a few of the 
bronchi or extensive, and involve the whole of them. Sometimes 
the inflammation extends upward into the trachea or downward into 
the terminal air cells of the luno;s. When the air cells are involved 
the disease is of great gravity, and is known as capillary bronchitis. 



316 THE NEW MEDICAL WORLD. 

CAUSES. 

The* causes of this disease are a damp climate, cold, -damp winds, 
sudden changes of the weather, wetting the feet, changing the under 
clothing too early in the spring, or taking cold. Bronchitis attacks 
those of feeble vitality, and hence old people and children are 
especially liable to it. Any depressing influences which unfavorably 
affect the health condition renders one liable to attacks, and it is 
often a complication of other diseases. 



SYMPTOMS. 

The first symptoms are usually a cold in the head with a watery 
discharge from the nose and eyes and frontal pain. This cold 
appears to travel downward toward the throat and chest. The 
patient complains of feeling chilly ; has a slightly inflamed or sore 
throat, a feeling of soreness in the chest, and complains of a disa- 
greeable smarting in the air passages and lungs. At first the cough 
is dry and hoarse — more troublesome toward evening, but later the 
mucous linings secrete an abundant amount of fluid, which soon 
becomes thick and viscid. Smarting of the lungs continues. The 
disease may last four or five days ; it may continue much longer, or 
even become chronic. There is usually a marked amount of bron- 
chitis in measles and typhoid fever. The breathing is not so much 
obstructed as in pneumonia. It is often a very serious disease for 
aged or debilitated persons and very young children. 



TREATMENT. 

The patient makes a more satisfactory recovery if confined to the 
bed. In the early stages foot baths of hot mustard water and hot 
drinks afford a measure of relief. Flaxseed tea and hot lemonade 
are good. If the mouth and throat are dry tablets of tartar emetic 
may be given in doses of one-twentieth of a grain or Hive syrup in 
doses of fifteen to twenty drops every two hours. A mustard plas- 
ter over the chest affords no little relief. If there is much fever the 
tincture of aconite may be given in drop doses and repeated every 



THE NEW MEDICAL WORLD. 317 

hour until the skin is moistened. Carbonate of ammonia is an excel- 
lent remedy in these cases. It may be given as follows : 

I£ Ammonia carbonate two drams 

Morphia acetat one grain 

Syr. ipecac. half an ounce 

Glycerine one ounce and a half 

Anise water one ounce 

Mix. Dose teaspoonful every two or four hours. 

The cough is necessary to clear the lungs. Stimulants are some- 
times required in some debilitated cases of old people. If necessary 
as a stimulant brandy can take the place of the glycerine in the above 
prescription in the same amount. 

For the restlessness of children do not give morphia but chloral in 
single grain doses will assist in relieving the overloaded air tubes. 
The following prescription for children is excellent : 

^ Hydrate of chloral sixteen grains 

Syr. ipecac. / two drams 

Syr. Tolu one ounce 

Anise water six drams 

Mix. Dose a teaspoonful every two or four hours. 

Y.— CAPILLARY BRONCHITIS. 

This disease is also called broncho or catarrhal pneumonia. It is 
an acute inflammation in the small bronchial air passages which 
extend to the air cells of the lungs. It is chiefly confined to the ex- 
tremes of life, infancy and old age. It is similar to bronchitis but a 
much more dangerous disease. It results from taking cold and from 
the same general causes as bronchitis. It is liable to follow measles, 
whooping cough, diphtheria and croup. 

SYMPTOMS. 

The symptoms closely resemble those of bronchitis, except that 
they are more severe. The respirations are short, superficial and 
greatly increased in number. The patient is restless, fitful, exacting, 
and not easily satisfied with constant attention. There is a high 
grade of fever and a troublesome cough. The disease has no definite 



318 THE NEW MEDICAL WORLD. 

course, it may be protracted for weeks or till the approach of warm 
weather. There is a constant tendency to relapse and to a chronic 
condition. 

The restoration of the lung which attends recovery often requires 
several weeks under the best treatment. 



TREATMENT. 

The temperature of the sick room should not be over seventy 
or seventy-two degrees. Moisture in the air is desirable and should 
be supplied by a kettle of water constantly boiling. An emetic of 
the syrup of ipecac, is frequently needed to free the lungs of mucous. 
No attempt must be made to suppress the cough, as it is the only hope 
of keeping the air cells open and preventing collapse of the lungs. 
The patient's strength should be maintained by good nourishment 
frequently administered. The following is an excellent prescription : 

1^ Carbonate of ammonia one dram 

Brandy half an ounce 

Syr. of liquorice one and one-half ounces 

Anise water q. s. to make four ounces 

Mix. Dose one teaspoonful and repeat as often as the condition 
requires. This prescription is intended for a child one year old. 
Older children may take a proportionate quantity. 

Cod liver oil favors recovery. 



VI.— PLEURISY. 

Pleurisy is an acute inflammation of the pleura, a membrane which 
lines the inside of the chest and which is reflected over the outside 
of the lungs. It is characterized by peculiar pain and by fluid in 
the chest cavity which is the chief element of danger in this disease. 

The inflammation is usually confined to one side but in a small 
proportion of cases extends to both. In occasional cases only a small 
and limited portion of the pleura is involved and the character of the 
disease is correspondingly modified. 

The cause of pleurisy is somewhat obscure. It is liable to occur in 
those who are somewhat debilitated. It occurs most frequently in 
the winter and spring and is usually attributed to taking cold. Aged 



THE NEW MEDICAL WORLD. 319 

persons and children are more subject to this disease than others be- 
cause they possess less power to resist it. Pleurisy occasionally re- 
sults from injuries as a fractured rib or extensive burns and scalds. 
When it results from such a cause it is known as traumatic pleurisy. 
It frequently complicates pneumonia and is then called pleuro- 
pneumonia. 



SYMPTOMS. 

It generally comes on suddenly sometimes with a slight chill or 
chilly sensations, but the most marked symptom is a sharp, cutting 
pain in the right or left side, which will not permit of taking a long 
breath. The breathing is short, shallow and difficult. The patient 
prevents the movements of the chest as much as possible for every 
breath when it reaches about such a point catches the sufferer with 
severe pain. The respirations reach forty or fifty a minute, the pa- 
tient tries not to breathe but is unsuccessful in the attempt. The 
temperature may reach an elevation of 102 or more degrees. The 
patient has a pinched countenance and wears an expression of suffer- 
ing. 

In the early stages of the disease the ear placed over the chest 
in the vicinity of the pain, detects the characteristic friction sound, 
which is caused by the inflamed surfaces grating against each other. 
The inflammation at first checks the secretion of the pleural fluid 
and two sore surfaces grate upon each other, causing a cutting and 
agonizing pain. Sometimes the disease does not complete its full 
course, recovery taking place quickly. Such an attack is called dry 
pleurisy. Usually, however, after a little time, an abundant quantity 
of serum or fluid is poured out into the cavity about the lungs. This 
fluid may be so abundant as to cause a bulging out of the spaces be- 
tween the ribs. The heart is crowded away from its place and the 
lung is pushed up into the apex of the chest, the pressure sometimes 
becoming so great as to drive all the air out of the lung and cause 
it to collapse. 

Pleurisy has some symptoms in common with pneumonia but there 
is a marked difference in the character of the breathing, the pain and 
the expectoration. In pleurisy the pain is cutting, the cough is short 
and suppressed and brings up no expectoration. In pneumonia 
the sputa is rust colored and the pain constant. 



320 THE NEW MEDICAL WORLD. 

TREATMENT. 

In the early stage the patient should go to bed. Hot applications as 
a flaxseed poultice containing a little mustard, sufficient to redden the 
surface, should be applied. Tincture of aconite in half drop doses 
every half hour to allay fever may be used. Moving about is to be 
avoided on account of the pain. Mild remedies should be adminis- 
tered to produce rest and sleep. Food should be nourishing and easy 
of digestion. Twenty grains of quinine may be given in the begin- 
ning of the attack in divided doses of five grains each, one every two 
hours. 

After removing the flaxseed and mustard poultice if the trouble 
continues, the patient should put on a cotton batting jacket covered 
on the outside with oiled silk. This is to remain on until after 
recovery. A five or ten-grain Dover's powder may be given to 
relieve pain and produce rest, and may be repeated every four 
hours. Simple cases tend to recovery, but severe cases may require 
other means to save life. 

The fluid in the pleural cavity may be absorbed. This is the most 
common and favorable result that can take place. It may fail to be 
absorbed and changed to purulent matter, when it will have to 
be removed. If left to itself it may affect a passage by ulcerating 
into the air tubes or bronchi, when it is raised through the mouth. 
It sometimes works a passage through the chest walls and drains 
away, but as these conditions of discharge are dangerous and liable 
to become chronic, it is better to puncture the chest cavity and draw 
off the purulent material without waiting for these more tedious and 
debilitating results. The operation requires considerable surgical 
skill and its details can well be omitted. It is better to operate 
as soon as the temperature indicates a change to pus and not wait for 
the tedious and destructive process which nature is obliged to 
pursue. 

Pleurisy, after recovery, usually leaves behind the proof of its 
former existence in adhesions formed between the lungs and chest 
wall. 

VIL— PNEUMONIA, INFLAMMATION OF THE LUNGS 

OR LUNG FEVER. 

Pneumonia is an acute inflammation of the lung tissues which 
causes serious embarrassment of the circulation and restoration. The 



THE NEW MEDICAL WORLD. 821 

real cause of pneumonia is disease germs. It is popularly and 
erroneously supposed to be occasioned by taking cold. 

There are certain predisposing causes, and taking cold, as well 
as climatic changes or the debilitating effects of cold weather, may 
be included among them. Persons recovering from serious illness or 
suffering from the debilitating effects of malaria, habitual drinkers 
and such classes, are more liable to attacks of pneumonia than 
the vigorous and temperate. Whatever, then, debilitates the system 
and taxes the vitality, may be regarded among the predisposing 
causes. 

Of all the mortality among aged people occasioned by acute 
disease, four-fifths is due to pneumonia, and this ratio increases as 
age advances. That pneumonia is due to a specific germ has been 
fully established. 

SYMPTOMS. 

The onset of pneumonia is usually sudden. The patient is taken 
with a chill, headache, pain in the back and limbs. The chill is soon 
followed by fever, pain in the chest, shallow, rapid and painful 
breathing, a short, hacking cough, and later on a rusty, blood- 
stained expectoration. If the ear is placed over the chest a crackling 
sound is heard, similar to that produced by rolling a hair between the 
thumb and fingers. All the symptoms do not appear at the same 
time, but one set of symptoms succeed another. The portion of 
lung first invaded is congested with blood. This condition lasts 
about two days, when the congested portion takes on a condition of 
solidification and resembles a piece of liver. The temperature is 
now high, ranging from one hundred and two to one hundred 
and five degrees. The urine is scanty and high colored. The 
patient's condition is one of anxiety and distress. The respirations 
increase and may reach from forty to sixty a minute, indicating that 
the functions of the lung are very much disturbed. This condi- 
tion lasts from two to three days. 

Should the case pursue a favorable course the solidified portion of 
lung begins to soften, the temperature falls rapidly, the fever de- 
clines, moisture appears upon the surface of the body and the patient 
begins to experience a sense of relief. This is the period of resolu- 
tion, in which the lung returns to its normal condition. It occimies a 
period of from two to six days. 



322 THE NEW MEDICAL WORLD. 

The disease does not always progress in the orderly way we have 
indicated, for frequently the process of inflammation extends from 
one portion of the lung to another, more and more of the lung 
tissue becoming involved from day to day. The disease, after 
traversing one lung, may pass over into the other, and is then known 
as double pneumonia. When the pulse advances beyond one hun- 
dred and twenty a minute and the temperature reaches one hundred 
and four degrees or more, the course of the disease is unfavorable, 
and is liable to terminate fatally. 

When the tongue is dry and brown the disease is sometimes 
called typhoid pneumonia to indicate its severity. Should the 
patient complain of a sharp stitch in the side the probability of 
pleurisy as a combination ought to be considered. Abscess of 
the lung has been known to follow pneumonia and then the re- 
covery is slow and tedious. 

TREATMENT. 

The treatment must be pronrpt and adequate to meet the symptoms 
as they arise. A poultice of ground flaxseed and mustard, of gen- 
erous size, renders excellent service if applied early. It should re- 
main until the skin is thoroughly reddened. Its removal may be fol- 
lowed by a stimulating liniment. The tincture of aconite is of es- 
pecial service in the early febrile condition. It should be given in 
small doses repeated every half hour till it moistens the surface. Ro- 
bust persons may take T ^ of a grain of tartar emetic every two hours. 
This is indicated only in the first stage. 

In the second stage carbonate of ammonia is an excellent remedy; 
five or ten grains may be given to an adult every two or four hours in 
syrup. High temperature should be controlled by safe remedies. 
Demulcent drinks made from slippery elm and flaxseed are bene- 
ficial. Many other remedies of undoubted efficiency are known 
to the medical profession which are unsuitable for domestic practice. 
The patient should be supplied with pure air as no harm can come 
from proper ventilation. The diet should consist of milk, animal 
broths, beef extract, malt and other suitable nutrients. 

VIII. — CONSUMPTION, PHTHISIS, OR TUBERCULOSIS. 

We must consider this interesting subject in a general manner 
since it is not worth while in a work of this character to dwell on 



THE NEW MEDICAL WORLD. 323 

those features of a disease which could be appreciated only by med- 
ical experts. Consumption is a very common disease and very fatal 
to the human family. 

Great progress in the study of this disease has been made in recent 
years. Late discoveries prove that but little was known of the causes 
of consumption even ten years ago. Consumption is now known to 
be a contagious disease caused by microscopic germs which are found 
to exist in the expectoration in great abundance. The reason that 
consumption was so long regarded as a hereditary disease is that cer- 
tain tendencies are transmitted which are favorable to its develop- 
ment. The habits of life, the unfavorable localities in which men 
live, and their employment may contribute much to produce those 
conditions favorable to its development. 

It is a very insidious disease, capable of deceiving the patient. 
When it progresses to a fatal termination it does so by undermining 
the powers of life, the appetite fails, digestion fails, the bodily weight 
diminishes, the muscular strength declines, fever is persistent, the 
pulse and respiration are rapid and the patient at last dies from ex- 
haustion. In the latter stages purulent expectoration becomes abun- 
dant and the cough fatiguing ; there is pallor and marked emaciation 
or waste ; a consumption indeed not merely of the lungs but of all 
the tissues of the body. 

SYMPTOMS. 

These are at first a dry cough, which persists and increases until 
finally an irritation is produced, which is accompanied by consid- 
erable expectoration. Hemorrhage may occur early in the dis- 
ease, and appears to afford in some cases a measure of relief. It 
may be profuse and, fatal. The voice may be husky, hoarse or 
whispering ; the pulse is quick and the temperature of the body 
is alwa} T s slightly elevated. If the disease is progressing rapidly the 
disturbance of the pulse and bodily temperature will be well marked. 
When the fever is highest there is usually a bright red spot on each 
cheek and the eye is bright and glistening. Profuse night sweats 
are often a source of discomfort to the patient. The blood is impov- 
erished and the appetite sooner or later fails. Diarrhoea is a common 
symptom and often attended by griping pains. The patient never 
ceases to expect and plan for recovery. The faculties of the mind 
are usually clear up to the last moment. In females the monthly flow 
usually ceases owing doubtless to anaemia and the poverty and emacia- 
tion of all the bodily tissues. 



o24 THE NEW MEDICAL AVORLD. 

TREATMENT. 

Many methods of treatment have been sprung upon the world 
as specific cures for consumption, but all of them have so far 
signally failed. Even the tuberculin of the celebrated Dr. Koch, 
which promised so much and created such universal interest in 
the press of the country, is now regarded as a failure. With our 
present knowledge it is impossible to administer or inhale any 
medicine which is strong enough to destroy the germ without harm- 
ing the patient. The future may remedy the difficulty and produce 
a specific that will arrest this desolating disease. 

Climate is a very important factor in the treatment of consump 
tion. Medicine in this disease is scarcely of more importance than 
hygienic measures. A dry climate with even temperature and a pure 
atmosphere, combined with healthy and well-cooked food, well venti- 
lated apartments and abundant outdoor exercise such as riding, driving, 
fishing and hunting with agreeable companions will benefit the pa- 
tient if the case is not too far advanced. A sea voyage has proved 
lbeneficial in some cases. That diverse employment, out of doors, 
should be sought after, which will increase the appetite, improve di- 
gestion and increase the bodily weight. 

Inability to take sufficient food to maintain the bodily condition 
is unfavorable. Among the numerous articles of diet suitable for 
such a patient are milk, cream, koumiss, buttermilk, eggs in liquid 
form, meats, beef, mutton, lamb, chicken or quail ; and if the diges- 
tion is unimpaired any other healthy food which is relished and es- 
pecially fattening foods. 

Medicines are given in this disease to improve the appetite, aid 
digestion and nutrition and to relieve any unfavorable symptoms. 
With respect to the use of alcoholic drinks the advice of an intelli- 
gent and conscientious physician should be sought and his direction 
followed. In many cases they are not essential while in others milk 
punch or egg-nog are considered advantageous. 

No remedy at the present time is yielding so good results as beech- 
wood creosote. It can be inhaled and taken internally. It has been 
injected into the diseased tissues with decided benefits. One-half to 
one grain should be taken in pill form three times a day ; its use 
ought to be continued until the health is well established. 

Nearly all cases are benefited by small doses of arsenic, as -fa of a 
grain in tablet form three times a day. It is the most efficient known 
remedy to prevent destructive waste of tissues. 



THE NEW MEDICAL WORLD. 3'25 

When the cough is so annoying as to prevent sleep sedative 
remedies are required. The following are old but efficient remedies: 

t} Extract of hyoscyamus fl. one and one-half drams 

Spirits of chloroform two drams 

Syr. of lactucarium two ounces 

Mix. Dose a teaspoonful every two or four hours. 
Should hemorrhage occur suddenly use a strong solution of com- 
mon salt until the following can be obtained. 

r) Extract of ergot fl. one ounce 

Syrup of orange peel one ounce 

Mix. Dose one teaspoonful, frequently repeated until the hemor- 
rhage subsides. 

Night sweats may be relieved by taking at night a tablet contain- 
ing yi-Q- of a grain of atropia. This remedy will also have a favorable 
influence upon the tendency to cough. 

IX.— THE PRETENTION OF CONSUMPTION. 

From reliable statistics we learn that consumption causes the 
remarkable mortality of about ninety thousand persons every year in 
the United States. Such a mortality indicates an amount of suffer- 
ing, distress and heartache on the part of patients and friends as to ex- 
ceed the power of thought or imagination. The importance 
of preventing this singularly fatal disease ought to awaken every- 
where the most enthusiastic interest. 

It is now known that consumption is caused by a rod-shaped 
disease germ or bacillus. The contagion is not communicated by the 
breath, for the sick and the well have often lived and slept together 
without its being contracted by the latter. It is always the sputa 
or expectoration which contains the germs in great number, and con- 
sequently this is the source of danger. If the expectoration is 
promptly disinfected and destroyed the danger is averted. 

When such precaution is not taken the germs are found clinging 
to the walls of a room which has been occupied by a consumptive 
patient, or upon the windows where they have been carried by 
the common house fly, which delights to feed upon such material. 

Expectoration upon the street is perilous to the healthy, for when 
it becomes dry the living germs are wafted about everywhere like 
dust or the seeds of the thistle. 



326 THE NEW MEDICAL WORLD. 

When we consider the carelessness of the people or their lack 
of knowledge upon this subject it is a wonder that every person, 
whether strong or weak, does not contract this terrible disease. 
That many do not proves that nature is strong to resist and destroy 
disease producing germs. 

The expectoration of consumptives ought to be disinfected and 
destroyed while it is moist. It should be discharged into cups con- 
taining a solution of corrosive sublimate, or upon paper or old pieces 
of muslin and burned up as soon as convenient. 

There are also other possible sources of contagion as infected milk 
or meat, for cattle are subject to this disease and no public system 
of inspection exists at present sufficient to prevent all danger from 
these sources. 

In a general way and in the line of prevention it may be said that 
a debilitated or consumptive mother ought not to nurse her infant. 
The milk fed to babies should be from healthy young cows kept in 
the country. 

School children ought always to be supplied with a healthy and 
nutritious diet and special cravings for food may be regarded as a 
hint which ought to be gratified, for nature makes use of a large 
amount of material in building up a healthy body. 

The importance of fresh air and sunlight are to be remembered as 
the means employed by nature for destrojung contagious germs. 

The apartments of sick persons should be frequently and thor- 
oughly cleansed and as well ventilated as the welfare of the patient 
will permit. 

Clothing ought always to be adapted to the climate and season in 
order to secure the comfort and well being of the patient. 

Where many persons are employed in shops, mills and mines the 
employer should be compelled to provide the best modern methods 
of ventilation. 

Some remarkable cases of recovery from incipient consumption 
have been correctly attributed to an abundant supply of fresh air and 
outdoor life without the aid even of medicine. Journeys on foot or 
on horseback, camping out in the vicinity of pine woods and long sea 
voyages have frequently resulted in restored health. If such means 
will cure this disease they will much more certainly prevent it. 

In the line of prevention the importance of proper inflation and 
development of the lungs ought to be more fully recognized. Seeds 
cannot germinate in any soil where they are subjected to constant and 



THE NEW MEDICAL WOELD. 827 

daily agitation. Perhaps these germs of disease cannot effect a lodge- 
ment in the hmgs if constantly agitated by the passing in and out of 
fresh air and an abundant supply of oxygen. We can at least see in 
this hint the necessity of standing erect and by forced inspiration 
fully expanding the lun^s, so that there shall be no nook or corner 
quietly left as a breeding place for disease germs. 

A narrow chest may be inherited, but a broad and full one can be 
successfully deyeloped. The following rule is a good one for all 
to follow. " Throw your shoulders back and draw in through your 
nose all the pure air possible, meantime elevating the chest so as to 
increase its circumference. Do this several times daily and continue 
doing it till you acquire the habit of deep and correct respiration, 
and when you have acquired this habit persevere in it through life." 



CHAPTER XIX. 
THE CESOPHAGUS AND STOMACH 



I. — The (Esophagus and its Affections. II. — Description 
of the Stomach and Digestion. III. — Dyspepsia or In- 
digestion. IV. — Gastritis, Gastric Fever, or Inflam- 
mation of the Stomach. V. — Gastric Ulcer, or Ulcer 
of the Stomach. VI. — Nausea and Vomiting. VII. — 
Gastralgia, Stomach Ache, or Neuralgia of the 
Stomach. VIII. — Cancer of the Stomach. IX — Loss 
of Appetite. X. — Unnatural Appetite. XI. — Hic- 
cough. 

I.— THE (ESOPHAGUS AND ITS AFFECTIONS. 

THE oesophagus is a vertical canal or tube extending from the 
throat or pharynx to the stomach. Back of it lies the spine and 
in front the trachea. It is simply a tube for the transmission of food 
from the mouth to the stomach. Its length is about nine inches, in 
its course it crosses over the arch of the aorta, passes through the 
diaphragm and terminates by means of an opening in the cardiac end 
of the stomach. It has three layers of membranes, a muscular, a 
cellular and a mucous. The mucous layer contains a numerous sup- 
ply of glands which secrete mucous. 

The oesophagus is of considerable interest to the surgeon on ac- 
count of its proximity to the aorta, the trachea, the pneumogastric 
nerve and other important tissues. It is not very liable to disease 
unless some caustic fluid is swallowed which may produce subsequent 
contraction or stricture. It is sometimes obstructed from the acci- 
dental swallowing of some foreign body as a set of plate teeth, a 
piece of bone or other substance. 

When a stricture occurs it may be dilated by the careful and re- 
peated passage of a bougie. A foreign body in the oesophagus as a 
piece of meat or fish bone, may be dislodged by an emetic or pushed 
down into the stomach or brought up by means of a bullet-pointed 



THE NEW MEDICAL AVORLD. 



329 



bristle probang. A foreign body so irregular as a partial set of plate 
teeth can be removed only by an operation which requires great 
surgical skill. 

II.— DESCRIPTION OF THE STOMACH AND DIGESTION. 

The stomach is an important organ of considerable size, situated 
below the diaphragm. Its position is transverse, the left portion 
is in contact with the spleen, and is much larger than the right. 
It is sometimes called the splenic or cardiac end. The right end 
tapers considerably in size and is known as the lesser or pyloric end. 

The stomach has four distinct layers or coats, a serous, muscular, 
cellular and mucous. The serous coat is a layer of the peritoneum, 
the muscular layer has three sets of fibres, longitudinal, circular and 
oblique. The cellular layer connects the muscular and mucous and 
lodges the blood vessels. The internal or mucous layer is thick, 
soft and velvety. 




A view of the interior of the stomach, showing the ridges or folds called the rugae and 
the mucous surface : a, oesophagus ; b, cardiac end of stomach ; c, pyloric end of stomach ; 
c, junction of stomach and duodenum ; d, duodenum. 

The stomach is much larger when distended with food than when 
empty. In the latter state it contracts and the mucous coat is thrown 
into longitudinal ridges or folds. It is liberally supplied with blood 
from the gastric, hepatic and splenic arteries, and with nerves which 
are branches of the pneumogastric and the sympathetic. The mucous 
membrane is liberally supplied with mucous and peptic glands. 



330 THE NEW MEDICAL WORLD. 

It is held in position by bands of omentum and a fold of per- 
itoneum. During digestion its muscular walls institute a sort of 
churning motion which mixes the food with the secretions of the 
glands. The stomach is the receptacle for food during the early 
process of digestion, to which process it renders important aid. 

The first act of digestion is the mastication of food in the mouth 
where it is crushed by the teeth and mixed with the saliva. The 
more thoroughly this preliminary work is performed in the mouth, 
the more promptly and efficiently will the digestive ferment act upon 
it when it reaches the stomach. The process of mastication in 
the mouth consequently becomes very important. Starchy foods in 
contact with the saliva are soon converted into a. sweet substance 
called glucose 

The saliva of the mouth is secreted and poured out abundantly by 
glands during mastication. The food after being thoroughly crushed, 
moistened and mixed with it is swallowed and forced onward into 
the stomach. 

The stomach is liberally supplied with glands which secrete a fluid 
which is essential to the digestion of food, namely, the gastric juice. 
This is a complex fluid composed of water, acid, common salt and 
traces of lime, magnesia, potash, ammonia, iron and a large amount 
of pepsin. . The most important ingredient of the gastric juice is pep- 
sin. Pepsin possesses the power of preventing putrefaction. It also 
arrests putrefaction after the process has begun to take place. Pep- 
sin must be combined with acid in order to act efficiently upon the 
food and in nature such combination always exists. Warmth aids 
the process of digestion, but too great heat as in boiling destroys the 
digestive power of pepsin. The properties of pepsin are destroyed 
by coming in contact with the secretions of the liver, especially bile, 
and this explains why digestion is so completely disturbed when an 
excess of bile enters the stomach. Food is then loathed and nausea 
and vomiting are persistent. 

The glands of the stomach act energetically, secreting and pouring 
out gastric juice rapidly after food has been taken, but their activity 
entirely ceases after the stimulus of food has been removed. 

The pyloric end of the stomach opens into the upper part of the 
intestines, the portion known as the duodenum. This opening is 
guarded by a valve-like arrangement which prevents the food from 
escaping from the stomach too soon. A very important part of di- 
gestion, however, takes place in the intestines. 



THE NEW MEDICAL WORLD. 331 

It is well known that disturbance of the nervous system interferes 
with the production of gastric juice and is often an important matter 
to be considered in connection with the affections of the stomach. 

Alcohol interferes temporarily with the process of digestion ; it 
precipitates the pepsin but does not destroy its properties and when 
diluted sufficiently with water it again becomes active. 

After eating it is a good rule not to think too much about the 
process of digestion. The stomach is exceedingly sensitive and re- 
sents being watched and distrusted. After eating it is a good idea to 
occupy the mind in a pleasant way or take a nap. 



III.— DYSPEPSIA OR INDIGESTION. 

Owing to irregular methods of living and excessive mental work or 
worry, dyspepsia is a common disorder. It is ordinarily a symptom 
of gastritis, and can hardly be called a disease unless it has become 

chronic and habitual. 

/ 

CAUSES. 

It is due to a functional disturbance of the digestive forces, hence 
whatever interferes with the complex process of digestion sooner or 
later brings on dyspepsia in some form, but at first it is usually mild. 

The constant influence of the nervous system upon all the 
processes of life must be remembered. The faithful fulfillment on 
the part of the nerves of their full share of work is essential to 
all vital processes and to the performance of every animal function. 

Strong emotions and mental overwork check the glandular secre- 
tions, and may be the means of arresting the process of digestion. 
Indigestion is chiefly due to a disturbed condition of the nervous 
forces of the stomach. Every one has observed how quickly some 
slight shock of the nervous system, as fright or bad news, will 
destroy the appetite, and even produce nausea or vomiting. The ex- 
citement of preparing for a journey on the part of children or those 
unaccustomed to travel, often destroys the relish for food, which 
if taken in such a condition could not be digested. 

The great mental activity so characteristic of American life, the re- 
sults of competition, haste to get rich, political and social ambition, 



332 THE NEW MEDICAL WORLD. 

success and failure, are all prominent in disturbing the physiological 
equilibrium which is so essential to healthy animal existence. 

Whatever depresses the vitality or disturbs the relation of the 
fibers of our organism may be reckoned among the causes of dyspep- 
sia. Warm weather is debilitating and the stomach is foremost in 
experiencing its effects. Little children who have been healthy from 
birth, at the first approach of hot weather are often unable to digest 
their food and such indigestion is the usual beginning of diarrhceal 
complaints and that dread disease, cholera infantum. 

People who live in hot countries are obliged to discard to a great 
extent fat meats and hearty food, and live upon rice and fruit. This 
is not always from choice but in the interest of health. 

A tendency to dyspepsia may be hereditary and when this is the 
case it usually manifests itself at an early age. 

Among the more common causes of dyspepsia should be empha- 
sized the imperfect and hasty mastication of food. In the mouth it 
is moistened with saliva and the starch begins to be changed into 
sugar by its chemical action. This process is essential. It takes time 
to do it. In our haste we drink water freely, swallow our food hastily 
and pay the penalty reluctantly, which is dyspepsia. Bolting the 
food, as it is called, is a vicious practice so far as health and longev- 
ity are concerned. 

Indigestible and unwholesome foods are commonly regarded as 
prominent causes of dyspepsia ; also excesses either in eating or 
drinking. It is reasonable to suppose that the introduction into the 
stomach of food in excess of the requirements of the body disturbs 
the balance between supply and demand and may cause sickness. 

Indigestible, unwholesome or badly cooked food, must of necessity 
disturb the terminal nerve filaments, having in charge the important 
process of digestion reacting unfavorably upon the disposition. 

Irregular methods of eating, as the taking of food at all hours, is 
detrimental and disarranges the functions of the stomach. Cooks 
from the habit of nibbling or tasting food constantly often lose their 
appetite for a hearty meal. 

The use of alcoholic liquors is a common cause of the very worst 
forms of dyspepsia. It produces chronic catarrh of the mucous coat 
of the stomach, while it disturbs the functions of the other digestive 
organs, as the liver and pancreas. 

The nervous forces weaken with old age. The stomach shares 
largely in this debility. The activity of the peptic glands is dimin- 



THE NEW MEDICAL WORLD. 383 

ished, and but little gastric juice is secreted. Old people, therefore, 
should eat less food and of a more simple kind than those whose 
mental and muscular efforts are vigorous. 

SYMPTOMS. 

These are, in brief, a sense of discomfort and fullness after meals, 
acid eructations, flatulence, regurgitation of food, and what is popu- 
larly called " heart burn," which is merely distress of the stomach. 
Dyspepsia seldom causes acute pain, only uneasiness. Other symp- 
toms may be dizziness, languor, drowsiness or inability to sleep, 
irritability, anxiety and despondency. 

Skin diseases, as eczema and urticaria are often among the many 
symptoms of dyspepsia. Constipation may also be experienced. 

TREATMENT. 

This should be largely preventive. Use wholesome and digestible 
food. Avoid raw vegetables, pastry, fried fish or steak and rich or 
greasy articles of diet. Avoid fresh bread, hot biscuit, heavy cakes 
and take time to masticate the food thoroughly. 

Those who tend to obesity should use potatoes, rice and other 
starchy foods, also cream and fat meats sparingly. 

Beef roasted or broiled, mutton, chickens, game and eggs, with 
bread a day or two old are good articles of food. Avoid despondency 
and every grade of worry so far as possible, for all morbid conditions 
affect the stomach and its work unfavorably. Avoid the excessive 
use of medicines and drugs. They are very seldom necessary in the 
intelligent treatment of this complaint. Improve the general health 
by such exercise in the open air as horseback riding, foreign travel 
and other suitable means. 

Koumiss and peptonized milk are excellent articles for a weak 
stomach. In prolonged and aggravated cases medicines may be 
needed to promote nutrition. Of the simple vegetable bitters which 
improve the appetite, gentian and nux vomica are worthy of favor- 
able mention. The latter is a very valuable remedy in cases of de- 
bility, impaired nutrition and resulting anaemia. Five to ten drops 
of the tincture taken in water three times a day after meals, is a suit- 
able adult dose. When there is partial arrest of the gastric secre- 
tions one or two grains of pure pepsin may be taken with or after 



334 THE NEW MEDICAL WORLD. 

each meal. Mineral waters may be beneficial in some cases. Bene- 
fit is sometimes derived from the administration of bismuth, iron and 
the mineral acids. Chief reliance should be placed, however, not 
upon such remedies but upon appropriate food, correct habits, taking 
care to avoid overwork and prostration, either mental or physical. 
Individual limitations should not be lost sight of as they are im- 
portant guides in the treatment of this common affection. 



IV.— GASTRITIS, GASTRIC FEVER, OR INFLAMMATION 

OF THE STOMACH. 

Gastritis is a common affection, and in addition to the above 
names it is sometimes called catarrh of the stomach. The inflamma- 
tion usually affects only the mucous lining, but sometimes the deeper 
tissues are involved. There are two forms of this affection, the 
acute and chronic. 

CAUSES. 

Various causes are assigned, but the more common are errors 
of diet or the abuse of alcoholic stimulants. Perhaps the use of 
substances too cold, or too hot, or the immoderate use of such articles 
as pepper, mustard and horse-radish, are worthy of consideration as 
possible causes. 

The stomach is weakened and made sensitive to inflammatory con- 
ditions by habits that are debilitating. It is especially sensitive 
to all. the irregularities and exhaustions of modern life. It is often 
the first organ to disclose approaching sickness, as acute fevers, and 
frequently the most unpleasant symptoms in acute disease is the 
irritability of the stomach. 

SYMPTOMS. 

The appetite is diminished or wholly lost. If food is taken 
digestion is labored, causing flatulence and other distresses. There 
may be much nausea and an intense loathing of all articles of food, 
together with pain in the region of the stomach, headache, vertigo 
and restlessness, with considerable fever and great thirst. There 
may be constipation or diarrhoea, faintness, hiccough, a coated 
tongue, foul breath and low spirits, but the most characteristic 
symptoms are persistent vomiting and thirst. 



THE NEW MEDICAL WORLD. 335 

TREATMENT. 

Pieces of ice may be held in the mouth to allay thirst. Ice- water 
containing a small amount of brandy may be allowed. It should be 
taken often in teaspoonful quantities. Minute doses of ipecac or 
tartar emetic may be administered with benefit, the latter in doses of 
ToW °^ a g ram - Lime water added to milk may be retained by the 
stomach. Two or three drops of pure carbolic acid may be added to 
half a glass of water and thoroughly mixed with it ; this mixture may 
be taken in teaspoonful doses and is very efficient to arrest fermenta- 
tion and allay vomiting. For chronic cases bismuth in doses of fif- 
teen grains or pure pepsin in doses of one or two grains are excellent 
remedies. Dilute muriatic acid in ten drop doses, well diluted with 
water, is often beneficial. Tincture of nux vomica in five drop doses 
is one of the best tonics in the chronic stage of this disease. When 
gastritis is due to the abuse of alcoholic stimulants it is necessary to 
abandon their use. The following prescription is a good one for 
chronic cases due to alcoholism. 

3. Tinct. of camphor two drams 

Tinct. of capsicum one dram 

Tinct. of nux vomica four drams 

Peppermint water q. s. to make ' four ounces 

Mix. Dose one teaspoonful in water every four hours. 

V .—GASTRIC ULCER, OR ULCER OF THE STOMACH. 

Among the several diseases of the stomach ulcer takes a prominent 
place, from the fact that it is a common affection of this organ. 

The causes do not seem to be determined, and whether it is 
in any way due to indigeston appears to be undecided. Some ob- 
struction to the circulation or blood supply appears to be the im- 
mediate cause, but why there should be such obstruction in the 
interior surface of the stomach rather than in other portions of 
the body is not easy to explain. 

SYMPTOMS. 

The most prominent symptom is hemorrhage, soon followed by 
vomiting of blood and exhaustion. If from a large vessel it may 
prove fatal. If the ulceration involves the deeper tissues there may 
be perforation of the stomach, followed by peritonitis collapse and 
death. 



336 THE NEW MEDICAL WORLD. 

TREATMENT. 

The treatment demands quiet, so that rest in bed should be in- 
sisted upon, and the preferable position for the patient is lying upon 
the back. Cold may be applied over the stomach in the form of ice 
water or ice. If a condition of collapse or extreme exhaustion exists 
the cold had better be omitted, bits of ice may be swallowed and 
warmth applied to the extremities. Brandy may be given in ice 
water if the condition demands a stimulant. Liquid food only 
should be administered, as milk and beef tea. Milk is preferable 
to all other articles of diet; it does not irritate. Lime water may be 
added to the milk with advantage. Suitable medicines for this 
affection are Fowler's solution in one, two or three drop doses three 
times a day after meals. It must be well diluted in water. Nitrate 
of silver in one-fourth grain doses three times a day is an efficient 
remedy. It should be given in pill form. It forms an albuminous 
coating over the ulcer and facilitates the process of healing under- 
neath. Bismuth in doses of fifteen grains is another remedy of 
great value. Rectal alimentation is sometimes necessary in order 
to give the stomach perfect rest. A case requiring such careful 
methods ought to be in the hands of a physician whose judgment 
must decide as to appropriate measures. 

VI.— NAUSEA AND VOMITING. 

Various minor affections of the digestive apparatus may be treated 
here appropriately. Some of them are not diseases but simply symp- 
toms so common as to deserve a few words of special notice. 

Nausea and Vomiting. — These are symptoms in many diseases, 
and often quite troublesome to manage. They accompany sea sick- 
ness and are caused by the motion of the vessel, which affects 
the brain and pneumogastric nerve. Many remedies have been sug- 
gested, and most of those tried have been more or less disappointing. 

A few of the more reliable remedies are the effervescing citrate of 
magnesia or hydrobromate of caffeine, the hydrate of chloral, lemon 
juice, carbonic acid water, champagne, cocaine in doses of one-tenth 
of a grain, and the hypodermic injection of morphia. 

For nausea and vomiting of pregnancy see diseases of pregnancy. 

When blood is A^omited it should be remembered that this is a 
prominent symptom in ulcer or cancer of the stomach. Falls, caus- 



THE NEW MEDICAL WORLD. 337 

ing concussion of the brain, are. followed by vomiting. Nausea and 
vomiting are common with the onset of scarlet fever. Vomiting 
occurs in digestive derangements and in functional disturbances 
of the liver. 

Obstruction of the bowels is followed by persistent vomiting, 
in which the contents of the bowels above the obstruction may 
at length appear in the vomited matter. Vomiting is a characteristic 
symptom in many varied affections. 

An emetic of warm salt water or mustard water to empty the 
stomach is proper in some varieties of vomiting, but would be inap- 
propriate in other forms. 

Vomiting is very weakening and distressing when long continued, 
and for this reason it often demands special attention. It requires at- 
tention in cholera morbus and cholera infantum, and may be allayed 
by carbolic acid or creosote in doses of a fraction of a drop well diluted 
with water, or by rectal injections containing a mixture of starch 
water and laudanum. Some physicians are fond of calomel in small 
doses to allay vomiting. One-tenth of a grain may be given as often 
as necessary until eight, or ten doses have been administered. 

VII.— GASTRALGIA, STOMACH ACHE, OR NEURALGIA 

OF THE STOMACH. 

This is a painful affection of a paroxysmal type, due to irritation of 
the terminal nerves of this organ, and familiarly known as stomach 
ache. When the nerves of the stomach are sufficiently irritated 
there arises painful contraction or spasm of the muscular fibers. 

The causes generally enumerated are indigestion, excessive acidity, 
stale or unsuitable foods, too rich food, delayed digestion, gas from 
fermentation of food, eating when exhausted, and anything which 
can derange the functions of the stomach. 

The chief symptom is pain, which is not constant but paroxysmal, 
and is relieved by pressure and lessened by walking. 

TREATMENT. 

Hot drinks often relieve, as ginger tea, a teaspoonful of the spirits 
of lavender compound in water, a few drops of the spirits of cam- 
phor, or five drops of oil of cajuput upon a lump of sugar, or two or 
three drops of choloform in glycerine, or a simple cup of hot water 



838 THE NEW MEDICAL WORLD. 

may afford relief. When the pain is very severe and is described by 
the patient as cramps, a teaspoonful of the spirits of chloroform mav 
be given in water, or if these fail to afford relief the hypodermic 
injection of an eighth of a grain of morphia may be administered. 
Hot applications or a mustard poultice may be applied to the 
stomach. The after treatment consists in regulation of the diet. 

VIII.— CANCER OF THE STOMACH. 

This common, and at length fatal disease, can be dismissed with 
few words. The stomach is more liable to be the seat of cancer than 
any other of the internal organs. The more common situation 
of this affection is about the pyloric orifice. It seldom occurs under 
forty years of age and terminates fatally, for no treatment can avail 
for its cure. 

The symptoms are pain, tenderness, vomiting of bloody mucous, 
indigestion, constipation, a sallow complexion and emaciation. 
Pain, though a common symptom, is not always exj:)erienced. 

TREATMENT. 

The diet should be regulated so as to be nourishing without irri- 
tating the stomach or aggravating the trouble, and should consist of 
liquid food. 

The pain should be relieved by hypodermic injections when 
necessary or anodvnes in a suppository, the dose varying with the 
amount of pain. 

For the vomiting creosote in one-half drop doses, given in some 
suitable syrup as acacia or glycerine, will be beneficial. Fowler's 
solution in doses of one to three drops three times a day is believed 
to retard the growth of this affection more certainly than any other 
remedy. 

IX.— LOSS OF APPETITE. 

In health the demand for food is quite regular; the thought of 
food adds to hunger, while the odor of savory articles causes an 
increase in the flow of saliva and gastric juice, and powerfully 
stimulates the appetite. In sickness the appetite is frequently im- 
paired, and sometimes the odor or even the thought of food causes 
nausea and disgust. 



THE NEW MEDICAL WORLD. 339 

Loss of appetite may be due to weakness or exhaustion, and it is 
usually very troublesome in consumption and other wasting diseases. 
It is to be expected in severe fevers and many acute diseases. The 
appetite returns with the recovery of health. If loss of appetite is 
protracted the patient is liable to lose more flesh and become more 
debilitated and anaemic, and recovery will be very much retarded. 

When loss of appetite persists the patient's condition will be 
improved by exercise in the open air and the administration of bitter 
tonics as mix vomica. The following tonic prescription may be used 
after debilitating diseases to improve the appetite and the general 
condition. 

5, Quinnia sulph. twenty grains 

Ext. mix vomica five grains 

Hydrastin ten grains 

Ext. gentian twenty grains 

Piperin five grains 

Mix and make into twenty pills. Dose one after each meal three 
times a day. 

If constipation exists add to the above prescription one grain 
of podophyllin. 

X.— UNNATURAL APPETITE. 

Sometimes instead of loss of appetite it becomes so unnatural, 
or ravenous as to exceed the ability of the stomach to digest the 
amount of food which is desired. This may occur in recovery from 
fevers and other acute diseases. In such cases caution must be 
used and good judgment exercised. Food should be given these 
cases at frequent intervals, and it must be of such a character as to be 
easily digested, else much harm maybe done. Worms are frequently 
the cause of an unnatural appetite ; they should be expelled by 
the remedies suggested. 

In pregnancy the appetite is often abnormal and ravenous. In 
some conditions of the system there is a strong craving for certain 
articles of food, as vinegar, lemon juice or other acids. This 
craving is sometimes manifested for unwholesome or unnatural 
substances, as chalk, plaster, ashes, starch and other indigestible 
articles. When the craving indicates the want of some ingredient 
which is essential for the health of the individual it may be ap- 
propriately supplied. 



340 THE NEW MEDICAL WORLD. 

XI.— HICCOUGH. 

Hiccough, though not strictly a disease of the stomach, may be 
appropriately mentioned here. It is the result of a spasmodic action 
of the diaphragm. It is thought to be caused by too rapid eating 
or the eating of irritating substances, or over-eating or drinking, or 
indigestion. It is quite troublesome to infants, but ordinarily is oth- 
erwise of little account. Only when it is persistent and due to 
exhaustion, or when it results from severe nervous disorders, should it 
be regarded as an unfavorable symptom. If due to an over-distension 
of the stomach an emetic will afford relief. Sometimes a swallow of 
water will cause its disappearance. In some persistent cases it has 
been found necessary to control it with the hypodermic injection of 
morphia or the internal use of anti-spasmodics. In some diseases 
approaching an unfavorable issue, hiccough appears as a very annoy- 
ing and persistent symptom, and seems to admonish that the end is 
not far away. In these cases no treatment avails. 



CHAPTER XX. 
THE LIVER SPLEEN AND GALL BLADDER 



I. — Description of the Liver and its Functions. II. — the 
Gall Bladder. III. — Diseases of the Liver in Gen- 
eral. IV. — Congestion of the Liver. V. — Jaundice or 
Icterus. VI. — Cirrhosis or Hardening- of the Liver. 
VII. — Gall Stones and Bilious Colic. VIII. — Other 
Affections of the Liver. 1, Abscess of the Liver ; 2, 
Cancer of the Liver ; 3, Fatty Degeneration of the 
Liver ; 4, Amyloid Degeneration of the Liver ; 5, 
Acute Yellovj - Atrophy ; 6, Hydatid Disease of the 
Liver. IX. — the Spleen and its Diseases. 1, Inflam- 
mation ; 2, Enlargement. 

I.— DESCRIPTION OF THE LIVER AND ITS FUNCTIONS. 

THE liver is a large organ situated upon the right side of the 
body below the diaphragm. It is, in fact, the largest glandu- 
lar organ in the body, and weighs in the adult three or four pounds. 
The region occupied by the liver is known as the right hypochondriac. 
A portion of the liver, the left lobe, extends to the opposite side into 
the left hypochondriac. The lower border of the liver extends to 
about the margin of the ribs, where it may be felt by the practiced 
hand. The upper border is convex and fits into the concavity of the 
diaphragm. 

The position of the liver is altered somewhat by change of posi- 
tion, as the rise and fall of the diaphragm in respiration, the disten- 
sion of the stomach with food, and dropsical diseases of the chest and 
abdomen. 

The liver is peculiar in shape and structure. It is made up of five 
lobes and five fissures, but since the liver of man is similar to 
that of other animals a familiarity with its appearance and structure 
may be assumed. 



342 



THE NEW MEDICAL WORLD. 



The liver is held in position by five ligaments, four of which are 
composed of folds of the peritoneum, the fifth being simply a rem- 
nant of foetal life. The right lobe of the liver contains the bulk 
of its substance, it being six times larger than the left lobe. 




The Liver, under surface of. 



The liver substance is made up of lobules held together by a mass 
of connective tissue and nourished and supplied by an extensive net- 
work of vessels. The blood vessels of the liver are peculiar. There 
are two sets, each supplied from a separate source. The first from 
the hepatic artery which furnishes the liver substance with nutrition, 
and the second from the portal vein, which carries to it a large sup- 
ply of venous blood from the stomach, the spleen, the pancreas and 
the intestines. This venous blood traverses the liver substance and 
supplies it with the material out of which its secretions are elab- 
orated. 

The liver has several important functions to perform. These were 
formerly the cause of much speculation, but modern research has 
added light to this subject. It had long been known that the liver 
secreted a large amount of bile. It has also been known to medical 
men that the liver is an immense sugar factory where starchy 
material is converted into a sweet substance like sugar, known 
as glycogen. This is considered the most important function of the 
liver, and is known as the glycogenic. 



THE NEW MEDICAL WORLD. 343 

It has been ascertained more recently that certain blood changes 
take place in the liver, such as the formation of white blood 
corpuscles and the destruction of red blood corpuscles, also that the 
formation of urea takes place in the liver. It is also agreed that the 
destruction of certain poisons which enter the liver through the 
portal circulation, and which are destroyed or prevented from enter- 
ing the general system, is one of the many functions of this organ. 
According to recent, careful investigations, certain waste of nerve 
tissue is restored by the action of the liver. 

From the foregoing it is not difficult to see that the functions of 
the liver are numerous, and that their healthy performance is essen- 
tial to the well being of the individual. Derangement of the 
functions of this important organ may cause diabetes, rheumatism, 
gout, and a disease which to-day is attracting much attention, 
namely, lithremia or lithuria, a condition in which lithic and uric acid 
are found in excessive quantities in the urine. 

The liver when overworked may produce more bile than the sys- 
tem requires, and this excess may inaugurate a condition of conges- 
tion generally recognizee! under the head of biliousness. 

The bile is a greenish colored viscid fluid, with a specific gravity 
of 1025. The quantity secreted by the liver begins to increase after 
a full meal. This fluid serves an important and essential purpose, 
although its full use is still somewhat obscure. It aids digestion by 
converting starch into sugar and fatty materials into an emulsion. It 
excites the normal action of the bowels, and is nature's great 
cathartic. It not only emulsifies fat but favors its absorption. The 
bile after performing these important functions is reabsorbed and 
again enters the circulation. 

An excess of bile causes headache, stupor, nausea, constipation, 
irritability and other derangements which burden the kidneys, upset 
the stomach and the whole system in general. 

When the sugar making function of the liver is deranged exces- 
sive quantities of sugar may enter the blood and appear constantly in 
the urine, causing that peculiar and fatal disease known as diabetes. 

Other functional disorders of the liver are believed to be impor- 
tant factors in causing rheumatism, gout and other diseases caused by 
an excess of uric acid. 

The liver contains a numerous supply of lymphatic vessels and an 
abundant supply of nerves. It also gives origin to a vast number of 
bile ducts, which collect and transport this fluid after it is secreted, 



344 THE NEW MEDICAL WORLD. 

carrying it on to the general reservoir for this fluid, namely, the gall 
bladder. 

II.— THE GALL BLADDER. 

The gall bladder is a pear-shaped sack about four inches long, 
attached to the under surface of the right or large lobe of the liver. 
It is a reservoir and capable of holding, when full, an ounce or more 
of fluid. It empties into the duodenum, the upper portion of the 
small intestines, by means of a duct, which joins another coming 
from the liver. The duct coming from the liver is called the 
hepatic, and that from the gall bladder the cystic ; and after the two 
unite they form the common duct which is about two inches long 
and about the size of a goose quill. It transports the secretions of 
the liver to the intestines, and is also the outlet of the gall bladder. 

The gall bladder, like the liver, is subject to a variety of diseases, 
both functional and organic. It is the frequent seat of catarrhal in- 
flammation, the formation of calculi and of abscess. Calculi are 
formed from the solid constituents of the bile, the gall bladder 
becoming simply the receptacle where they may be retained. The 
duct may be obstructed so that the bile cannot flow out into the in- 
testines. In such cases jaundice supervenes. 

III.— DISEASES OF THE LIVER IN GENERAL. 

The liver, until recently, has been rather of an obscure organ. It 
has been customary to blame it for many derangements, making it a 
sort of scape goat for ignorance and obscure affections. 

Functional derangements of the liver are frequent and are gener- 
ally classed under the indefinite term, biliousness, Since so much is 
said about this affection in medical literature and in the advertise- 
ments of patent medicines and nostrums, it is timeh r to notice what 
ought to be understood upon this subject. Many functional dis- 
turbances of the liver are due to the food supply, the process of 
digestion and absorption furnishing this organ with a direct and 
enormous supply of material and blood. 

If the amount of food is too rich and abundant to satisfy the 
demands of nature the liver is likely to suffer from over nourish- 
ment, overwork and congestion, leading to a series of important 
derangement, which will be more fully noticed in the following 
pages. It is to be remembered that in all affections of the liver the 
diet is of great importance. 



THE NEW MEDICAL WORLD. 345 

IV.— CONGESTION OF THE LIVER. 

This affection, as already intimated, is known in common language 
as biliousness. It indicates that the liver is embarrassed by receiving 
too large a supply of material and blood, or in other words, that the 
food supply has been too abundant or not rightly proportioned. 
The food may contain an excessive amount of sugar, starch or fat, or 
may be otherwise too rich and abundant. 

The causes of congestion of the liver are habitual excess in the 
eating of foods too concentrated or too stimulating. This condition 
is more liable to occur where high living is coupled with the use 
of alcoholic stimulants and sedentary habits. 

Hot climates, malarial districts and disturbance of the nervous 
system, are factors which emphasize the frequency and importance of 
this affection. In certain fevers and affections of an inflammatory 
character the liver may be congested. Certain diseases of the 
lungs and heart may obstruct the circulation to such an extent as to 
cause a congestion of the blood vessels of the liver. 



SYMPTOMS. 

These are in general a coated tongue, loss of appetite, nausea, 
headache, pain, dullness or a sense of fullness upon the right side, 
bitter taste in the mouth, rise of temperature, and sometimes jaundice 
of a mild type or a sallow appearance of the skin. The urine is 
usually highly colored, and a deep breath causes discomfort or pain. 



TREATMENT. 

Rest of the digestive organs is important. The diet should be 
carefully regulated and a few simple directions followed which will 
often enable nature to afford relief without the aid of medicine. 
Saline mineral waters are sometimes helpful to cleanse the clogged 
and over burdened system. Epsom salts may be used for this purpose, 
in dessert spoonful doses dissolved in water or coffee. Podophyllin 
in doses of one-tenth of a grain continued for several days, arouses a 



346 THE NEW MEDICAL WORLD. 

sluggish liver and assists in regulating its functions, A pill composed 
of the following remedies, works well in chronic cases ; 

1^ Podophyllin one grain 

Extr. of mix vomica two grains 

Euonymin ten grains 

Irisin ten grains 

Ipecac. four grains 

Extr. of hyoscyamus two grains 

Mix. Make into twenty pills. 

Dose one or two pills each night for two or three weeks. This 
will usually relieve the most chronic and obstinate cases. 



V.— JAUNDICE OR ICTERUS. 

Jaundice though not a disease of itself, is yet so important as a 
symptom as to demand special notice. It may result from a large 
number of causes such as catarrhal inflammation of the gall bladder and 
gall ducts, an accumulation of gall stones causing obstruction or any 
pressure upon the liver and bile ducts which prevent the outflow of 
this secretion. 

The development of a cancer or other tumor or even pregnancy may 
cause obstruction of the bile ducts. In some diseases of the liver 
as acute yellow atrophy, jaundice is a well marked symptom. When 
there is obstruction of the bile ducts, the bile is absorbed into the 
general system when it enters the blood and changes its character. 
It also affects the nervous system. 

In the bowels the bile aids digestion, absorption, and stimulates 
them to a healthy action, but when taken into the blood it acts as a 
poison. 

SYMPTOMS. 

The bile out of place creates much general disturbance. The 
coloring matter which it contains permeates all the tissues of the 
body and gives to them a yellowish, or in some severe cases, more of 
a greenish hue. This coloring of the tissues is usually most notice- 
able in the whites of the eyes. It can not be so well observed by 
lamp light as in daylight. The urine is highly colored and the 



THE NEW MEDICAL WORLD. ^47 

perspiration stains the linen yellow. When the obstruction is so 
complete that no bile passes into the intestines, the stools lose their 
natural color and resemble chalk or clay and the bowels are usually 
obstinately constipated. The disposition is affected, the patient is 
usually irritable, low spirited and despondent. 

Digestion is disturbed, the appetite is poor, and food causes 
flatulence. The pulse is slow and the patient feels wanting in 
ambition and is not inclined to labor. The skin is yellow, dry 
and itchy, the mouth is dry and the tongue coated. There is often 
nausea and vomiting, there may be chills, alternating with fever, pain 
in the abdomen and pain extending into the right shoulder. 

When delirium and stupor occur the case is usually critical, 
although delirium in the hot stage following a chill is not to be 
regarded as an unfavorable symptom. 



TREATMENT. 

i 

The treatment consists in regulating the diet. Foods composed of 
starch, fat and sugar should for the most part be avoided. Medi- 
cines are needed to stimulate the eiiminative functions so as to 
get rid of the excess of bile as speedily as possible. 

Podophyllin in doses of one-twentieth to one-tenth of a grain two 
or three times a day does its work well, and in most cases improves 
the action of the liver. Sometimes a brisk cathartic is needed. 

Excess of bile is eliminated also by the kidneys and to aid them in 
their important work diuretics such as cream of tartar water is bene- 
ficial. Acid drinks, as cream of tartar lemonade, are refreshing and 
grateful to the patient. A decoction of barberry bark and sour 
cider had considerable reputation formerly in domestic practice, and 
no doubt was often beneficial, but the cream of tartar lemonade 
is preferable for several reasons. 

A mustard poultice placed over the liver externally, is beneficial 
and a fly blister is of decided advantage in very obstinate cases. The 
treatment of jaundice depends largely upon its cause, when it is due 
to functional disturbance it yields readily, but when due to organic 
diseases it is often very obstinate and persistent. 

Jaundice of malarial origin is benefited by bitter tonics the best of 
which is probably quinine, cinchomdia, or chinoidine. The follow- 



348 THE NEW MEDICAL WORLD. 

ing prescription cures jaundice of malarial origin usually in a short 
tjime : 

^ Cinchonidia forty grains 

Podophyllin one grain 

Euonymin ten grains 

Extr. of taraxacum forty grains 

Oleo-resin of ginger ten drops 

Mix. Make twenty pills or capsules. 

Dose one three times a day until recovery ensues. 

When jaundice is caused by a catarrhal condition of the bile duct 
the phosphate of soda may be used with benefit in doses of twenty 
grains three times a day. This remedy can be taken agreeably in 
milk. The drinking of hot water and the use of hot baths are often 
beneficial. 

VI.— CIRRHOSIS, OR HARDENING OF THE LIVER. 

This disease takes its name from the fact that the liver becomes con- 
tracted and hardened. It is also called hob-nail liver or gin-drinkers' 
liver. It is a chronic affection and caused chiefly by the excessive 
use of alcoholic liquors. This disease rarely appears before adult 
life, and more frequently in the male sex. Those who drink strong 
alcoholic liquors without diluting them with water are the most 
liable. 

SYMPTOMS. 

The early symptoms are liable to be overlooked or confounded 
with dyspeptic troubles. This is unfortunate, for there is no perma- 
nent help for this affection when it has reached a chronic condition. 

In the first stages the symptoms are identical with those of con- 
gestion of the liver and are mistaken for indigestion and biliousness. 
The liver is enlarged and pressure over it reveals tenderness and 
pain. Following the stage of enlargement is the opposite condition 
of contraction and induration. When contraction of the liver ensues 
it becomes nodulated, the circulation is obstructed and another class 
of symptoms present. When the circulation of the liver is thus in- 
terfered with the spleen becomes enlarged, piles are troublesome and 
the blood vessels on the surface of the abdomen become large and 



THE NEW MEDICAL WORLD. 349 

prominent. Dropsy of the feet and ankles is noticed which tends to 
extend up to the abdomen, and jaundice, though not a regular symp- 
tom, may occur. 

The whole digestive apparatus is disordered, the appetite is poor, 
food occasions distress, gas and acidity of the stomach are trouble- 
some and the bowels may be constipated. The patient loses strength 
and has a waxy and sickly appearance. The general condition is 
that of sallowness and emaciation, with well marked dropsical 
tendencies. The disease may last two or three years before the 
death of the patient occurs. 

TREATMENT. 

The only hope for these cases is in their early treatment during 
the stage of congestion and before induration has taken place. The 
diet ought to receive appropriate attention. Foods highly seasoned 
or rich in starch, sugar or fats, must be used very sparingly or 
abandoned and the use of alcoholic liquors regulated or prohibited. 
Congestion of the liver at this stage needs to be relieved by the use 
of alkaline waters, or podophyllin in small and repeated doses. 

The functions of the skin and kidneys should receive attention. 
When the disease has advanced to a hopeless stage, but little can be 
done except to combat the unfavorable symptoms and such means 
must be employed as the condition of the patient demands. Flannel 
should be worn next to the skin. Hot poultices may be applied over 
the liver and tapping may be essential to draw off an excess of fluid 
from the abdomen. 

The suffering which this lingering disease entails, should cause 
every one to contemplate the use of alcoholic drinks with alarm. No 
organ is more directly or more unfavorable affected by the continued 
use of alcohol than the liver. Next to this organ the spleen and 
kidneys feel the unfavorable force of this widespread habit. See 
chronic alcoholism. 

VII.— GALL STONES AND BILIOUS COLIC. 

These are due to a solidification of the constituents of the bile and 
just why this should take place it is difficult to determine. A second 
attack of gall stones is usually much dreaded by those who have ex- 
perienced a previous one, for in passing through the duct they cause 
excruciating pain. 



350 THE NEW MEDICAL WORLD. 

They vary in colors and in numbers. In some cases only one 
calculus exists, in others many, and in still others they are so 
numerous as to completely fill and distend the gall bladder. Their 
average size is about that of a small pea, but in this respect there is 
also great variation. 

SYMPTOMS. 

These are severe pain, nausea, vomiting, flatulence, and sometimes 
diarrhoea. The pain is called bilious colic and is accompanied by an 
expression of great anxiety. It is felt in the right side over the 
region of the liver and sometimes extends to the right shoulder. At 
times it is agonizing with clammy skin, weak pulse, and other 
symptoms of prostration. An attack may last a few minutes or 
several hours. The pain usually calls loudly for relief. 

TREATMENT. 

Such applications externally, as the hot pack and mustard plasters 
often afford a measure of relief. Ether may be inhaled carefully or 
anodynes administered, but the most efficient means is the adminis- 
tration of morphia hypodermically. Sweet oil in large doses has 
been much lauded as an effective agent for the removal of gall stones. 
It produces better results when combined with castor oil. The dose 
should be large and frequently repeated for one or two days. 

After the subsidence of the pain, the gall, stones may be found in 
the stools. After a person has once suffered from an attack of gall 
stones, much attention should be given to the general health to pre- 
vent subsequent attacks. The diet ought to be carefully regulated 
and rich food eliminated. Exercise in the open air is important and 
the bile may be rendered thinner and less likely to solidify by the use 
of appropriate mineral or alkaline waters. 

VIII.— OTHER AFFECTIONS OF THE LIVER. 

There are several other affections of the liver which are either too 
rare or of insufficient interest to engage general attention except to a 
very limited degree. 

Abscess of the Liver. — This occurs as the result of blood poison- 
ing, pyaemia, or it may be due to the debilitating effects upon the sys- 
tem of a tropical climate. In temperate regions it is a disease of rare 



THE NEW MEDICAL WORLD. 351 

occurrence. Injuries have sometimes been followed by an abscess of 
the liver. The symptoms of hepatic abscess are obscure in the early 
stages, but later they are prominent. The first symptoms are of a 
general character, such as a chill, pain in the back and limbs, head- 
ache, coated tongue, nausea, vomiting, local pain and rise of pulse, 
with rise of temperature. The duration of this affection is irregular 
and uncertain. When left to itself the abscess will rupture and 
recovery may ensue. Should it rupture into the peritoneal cavity it 
would be likely to cause collapse and death. Surgical interference 
may be called for, and may result in saving the patient's life. An 
abscess of the liver requires careful watching and skillful treatment. 

Cancer of the Liver. — This is of comparatively frequent oc- 
currence. Its cause is obscure. The symptoms are similar to those 
of cancer of the other internal organs. They are local uneasiness 
in the region of the liver, pain, emaciation, low spirits, dropsy, and 
the peculiar waxy look which is characteristic of cancerous disease. 

The treatment must palliate the symptoms, as no cure can be 
expected. The diet should receive attention, the pain should be 
relieved and the patient should be made comfortable. 

Fatty Degeneration of the Liver. — In this disease the liver 
substance seems to have changed to fat and the organ is enlarged, 
smooth and soft. It is not tender upon pressure and jaundice and 
dropsy which call attention to the liver so frequently are wanting, 
hence there are few symptoms to give rise to the suspicion that the 
disease exists. 

In the treatment an effort should be made to improve the general 
condition. Medicines are of but little service except tonics, to im- 
prove the appetite and strength. A tendency to the accumulation of 
fat should be obviated by the means recommended for the treatment 
of obesity. 

Amyloid Degeneration of the Liver. — This disease is so called 
because material resembling starch, is deposited in the tissues of the 
liver which, in consequence, becomes much enlarged. It is also 
known as lardaceous or waxy liver. It is due to prolonged suppura- 
tion and bone disease, necrosis. Syphilitic and malarial affections 
have been suggested as causative factors. The functions of the liver 
are much disturbed. Well marked cases do not recover, and no 
appropriate line of domestic treatment can be suggested. 



352 THE NEW MEDICAL WORLD. 

Acute Yellow Atrophy. — In this disease the entire liver is in- 
volved. It is rapidly diminished in size and a destruction of the cells 
takes place. There is nausea, vomiting, severe pain, and jaundice 
which is always present. The spleen is also enlarged. It sometimes, 
though rarely, occurs during pregnancy, and hereditary syphilis, has 
been suggested as a cause. Medicine is powerless to improve the 
general condition, or to arrest the intensity of the disease, but should 
be used as needed, to relieve pain and add to the patient's comfort. 

Hydatid Disease of the Liver. — This disease is prevalent 
in some portions of the globe. It is due to a parasite, the eggs of 
which may be contained in the faeces of the dog. Those who live 
in filthy habitations, surrounded by animals, as do the inhabitants of 
Iceland are subject to this undesirable affection. Cleanliness and 
care in associating with dogs, is a means of prevention. Medicines 
taken internally have little or no effect. Surgical means are sometimes 
essential and successful. 

IX.— THE SPLEEN AND ITS DISEASES. 

The spleen is a small organ or gland, ordinarily weighing only 
about seven ounces. It is situated at the left end of the pancreas and 
near the cardiac end of the stomach. Its substance is dark red in 
color and quite brittle. It is very liberally supplied with blood. 
Its outer surface is convex and its inner concave. It is only about an 
inch to an inch and a half in thickness. It is held in position by 
ligaments formed from folds of the peritoneum. Its size is in- 
creased by the taking of food. It is also larger in the well fed than 
in those poorly fed or suffering from hunger. Its size is diminished 
in old age. Its minute structure is of interest only to the student of 
anatomy or the medical practitioner. 

In intermittent fevers and in diseases of the liver it is liable to 
be congested, and sometimes it attains an enormous size. In malarial 
regions it has been known to enlarge until its weight reaches eighteen 
or twenty pounds, distending the abdomen to an unusual degree. 

The functions of the spleen are somewhat obscure, but when it is 
disturbed by disease the quality of the blood in the body appears 
to be correspondingly affected, its specific gravity becoming reduced 
and its condition becoming thin and watery. There is also a dis- 
turbance of the relative quantity of the white and red blood cor- 
puscles, the patient feels weak and there is a tendency to a dropsical 



THE NEW MEDICAL WORLD. 858 

condition. From these facts we may infer that the function of the 
spleen is to assist in maintaining the normal condition of the blood, 
and the proper proportion between the white and red blood corpus- 
cles. 

Inflammation of the Spleen. — With regard to diseases of the 
spleen, there is but little that needs to be said. It may be inflamed 
by injury, or perhaps from other obscure causes. When this condi- 
tion is suspected, the bowels should be moved with saline cathartics, 
and generous doses of quinine administered. 

Enlargement of the Spleen. — In malarial sections, this condition 
is common. In its treatment the most satisfactory results are ob- 
tained from the administration of quinine, used in connection with 
doses of Fowler's solution, three or four drops of which well diluted 
with water, are to be taken after each meal. 

Diseases of the spleen except excessive enlargement are recognized 
with difficulty, and their management is similar in principle, to dis- 
eases of the liver, owing to the intimate relation of the two organs. 
The tincture of iodine painted over the region of the spleen may be 
of some benefit in enlargement of this organ. The syrup of hy- 
driodic acid in teaspoonful doses, is likely to be of benefit. It. 
should be taken in a little water. 



CHAPTER XXL 

THE HEART, CIRCULATION, PERICARDIUM, 
BLOOD VESSELS, AND THEIR DISEASES. 



L — Description of the Heart and its Valves. II. — The Cir- 
culation. III. — Overwork of the Heart, or Heart 
Strain. IV. — The Pericardium, or Heart Sac. V. — In- 
flammation of the Heart Sac, or Pericarditis. VI. — 
Valvular Disease of the Heart, or Endocarditis. VII. 
— Angina Pectoris, or Neuralgia of the Heart. VIII. — 
Palpitation. IX. — Various Other Diseases of the 
Heart. 1, Hypertrophy, or Enlargement of the Heart. 
2, Fatty Degeneration. X. — The Blood Vessels, and 
Their Diseases. 1, Aneurism ; 2, Varicose Veins. 

1.— DESCRIPTION OF THE HEART AND ITS VALVES. 

THE heart is a powerful muscular organ, placed between the lungs 
somewhat obliquely in the left side of the chest above the dia- 
phragm ; where its motion can be felt by the hand and its sounds 
heard by the ear. 

The great function of the heart is to maintain the circulation of the 
blood. It performs this work with marked fidelity, from birth to 
the close of life, never stopping to rest for a single instant, day or 
night. It beats, on an average, seventy-two times a minute in an 
adult, and about one hundred and twenty times a minute in a newly 
born infant. 

The shape of the heart is that of a cone, with the apex downward, 
the base upward, and from one to the other, the distance is about 
five inches. The diameter of the base is about three and one-half 
inches ; its average weight is from ten to twelve ounces, depending 
upon the size of the individual. 



THE XEW MEDICAL WORLD. 



355 



The heart is composed chiefly of muscular fibres, arranged in 
layers which interlace each other. Many of these fibres are circular, 
and in contracting, squeeze the blood out of the internal hollow 
cavity in which it is allowed to remain scarcely for an instant. 

The contraction of the heart is known as the systole, and its relax- 
ation the diastole, the one movement alternating with the other. 

The heart is divided by a muscular partition into two halves, 
known as the right and left heart or sides. The right heart is known 
as the venous side because it receives and transmits the venous blood. 
The left heart is the arterial side, and receives and transmits the 
arterial blood. 




Front view of heart and lungs. The borders of the lungs have been turned back to show 
relation of heart and its vessels. 

The muscular walls of the left side are thicker and stronger than 
those of the right owing to the greater force required to send the 
arterial blood thorougdiout the body. Each side of the heart is 



356 



THE NEW MEDICAL WORLD. 



further divided into apartments, an auricle and a ventricle, four 
cavities in all, two auricles and two ventricles. The necessity for 
this arrangement can be seen when we come to understand the 
circulation. 

The heart muscle receives its nourishment from two small arteries, 
the right and left coronary, the first branches of the aorta just out- 
side of the semilunar valve. Its nerve supply is abundant from the 
sympathetic and cerebro-spinal system. 

The valves of the heart are an ingenious arrangement permitting 
the blood to flow freely only in the direction in which it ought to go, 
and by closing at the right instant they prevent the blood from flow- 
ing in the wrong direction. If from any reason the valves of the 
heart do not close tightly, a portion of the blood flows back after each 
stroke, a condition common in valvular disease. 




The heart with the right auricle and right ventricle laid open to show the interior 
structure 

The valves between the left auricle and the left venticle are known 
as mitral ; the valves which guard the outlet of the left ventricle 
are known as the semilunar. The mitral and semilunar valves 
of the left side are much more liable to be disabled and suffer from 



THE NEW MEDICAL WOKLD. 357 

disease than the valves of the right heart, because the left ventricle is 
larger and stronger than the right and contracts with greater force. 
Hence these valves are subjected to a powerful and constant strain. 
The valves of the right heart are the tricuspid and semilunar. 
The tricuspid guard the opening between the right auricle and the 
right ventricle, and the semilunar guard the opening of the pulmonary 
artery. The left ventricle is obliged to contract with sufficient force 
to keep the blood current moving throughout all parts of the body, 
while the right ventricle is obliged to contract only with sufficient 
force to accomplish the pulmonary circulation. 

IL— THE CIRCULATION. 

In order to understand the work of the heart in maintaining the 
circulation, it is necessary to follow the blood current passing out 
from the heart, until it returns again. The left auricle receives the 
blood coming from the lungs, where it has been oxygenized. It is 
bright red, arterial blood, and passes from the left auricle to the left 
ventricle, when the left 1 ventricle instantly contracts, it is prevented 
from flowing back into the auricle by the mitral valves which instantly 
close ; simultaneously with their closure, the semilunar valves open, 
allowing this blood current to be forced into the aorta, after which 
they instantly close and prevent its returning, and this process is 
constantly repeated. The blood forced into the aorta is now pushed 
forward by each heart stroke, a small portion of it entering the coro- 
nary arteries, to nourish the heart, and every other branch in turn 
throughout the whole body. These branches are numerous, and the 
size of the arteries is constantly diminishing, until they become so 
small that they are scarcely visible to the naked eye. 

These little minute vessels form a net work throughout the tissues 
of the whole body, and are called capillaries. By the time the blood 
current has reached these little vessels, it has lost the spurting char- 
acter imparted to it by the heart beat, and flows in a steady, minute 
stream, giving nourishment to every organ, tissue, and part of the 
body, and receiving in turn worn out products, which must be elim- 
inated by the liver, kidneys and skin. 

After the blood has passed through this extensive capillary net- 
work it emerges into larger tubes called veins, which converge 
toward the heart. The blood has now become changed in color and 
character and is known as venous blood. It comes from every direc- 



358 THE NEW MEDICAL WORLD. 

tion and enters the right auricle of the heart, through the superior 
and inferior vena cava. 

It passes from the right auricle into the right ventricle. Instantly 
the right ventricle contracts, the tricuspid valves close, the semilunar 
valves open, and the blood is forced into the pulmonary artery. It 
ought to be observed at this point that the pulmonary artery trans- 
ports venous blood, and the pulmonary vein arterial blood. 

By the repeated contraction of the right ventricle the venous 
blood is forced through the pulmonary artery until it reaches the 
lungs, where it comes in contact with the oxygen of the air, the 
blood and the air being separated from each other only by a very 
thin, moist membrane. Through this thin membrane the carbonic 
acid gas which the venous blood contains passes out, and oxygen 
from the air passes in. Thus the color of the blood is again changed 
or oxygenized. After this process has taken place it is rapidly 
forced on into the pulmonary veins and flows into the left auricle. 
This completes the circuit and process called the circulation. 

It may be observed that this process is a double one, the left heart 
maintaining the circulation of the body and necessary for its nourish- 
ment ; the right heart maintaining the circulation of the lungs and 
necessary for the purification of the blood. The heart, then, is 
a double pump maintaining a systemic and a pulmonary circulation. 

The circulation is an interesting, though complex process. While 
it is taking place, urea and other waste products are being eliminated 
from the blood by the kidneys ; other products are being eliminated 
by the liver, carbonic acid gas escapes and other waste products pass 
out through the sweat glands. Thus nature is making a constant and 
heroic effort to keep the life giving current pure. 

Because the arteries were empty after death, they were once sup- 
posed to be hollow tubes, through which only air was conveyed. In 
order to understand the circulation, it is necessary not only to follow 
the blood in its course through the body, but to observe the changes 
which take place in it as it comes from the kidneys, liver and lungs. 
Nor is this all. The blood is constantly being influenced by forces 
coming from without; as the food which we eat, by means of 
digestion and absorption, is conveyed into the circulation, to enrich 
and maintain the blood supply. The circulation is intimately related 
to the process of respiration, digestion, absorption and elimination. 
For all of these processes the heart simply supplies the force, and 
without its action there would be immediate stagnation and death. 



THE NEW MEDICAL WORLD. 859 

Before the lungs are expanded with air, only sufficient blood is 
sent to them for their nutrition, but when their inflation takes place, 
the blood must be sent to the lungs, and oxygenized. Hence a re- 
markable change takes place in the circulation at birth. Prior to 
birth, there is an aperture or opening between the two auricles, 
throuo-h which the blood passes, and the pulmonary circulation has 
not yet been established. At birth, this direct opening between the 
two auricles is closed up, and adult circulation takes place. 

HI.— OVERWORK OF THE HEART, OR HEART STRAIN. 

There is no organ in the body, more liable to overwork than the 
hearto Its activity is constant. When the body is in a state of re- 
pose, the heart must continue its work. If increased effort or 
greater activity is rendered necessary, as in running or severe labor, 
the heart beats more rapidly in order to supply the requisite force. 
When extreme effort is carried too far from overwork or protracted 
effort, the stomach becomes feeble, the limbs tremble, the muscles 
lose strength, the face is^ care-worn, the skin is shriveled, the memory 
falters, and the signs of old age appear, even though years do not 
indicate the autumn of its approach. There is no excitement, emo- 
tion or over-exertion which does not perceptibly touch and affect the 
heart. Therefore it is wise to avoid violence to this all important 
organ. 

IV.— THE PERICARDIUM, OR HEART SAC. 

The heart is surrounded by a membranous sac called the peri- 
cardium, w T hich is a reflection of its outside covering. It also sur- 
rounds the great vessels which arise from the heart for a distance of 
two inches. It is composed of two layers, an external or fibrous, and 
an internal or serous. The serous layer covers the external surface 
of the heart and the internal surface of the sac. It is smooth and 
glistening. It secretes a lubricating fluid about the consistency of 
glycerine, which keeps the membrane moist and prevents friction 
and disturbance, as a result of the incessant motion of the heart. In 
health there is always a small quantity of this fluid contained within 
the sac. In disease it may be deficient, excessive, or its character 
may be altered. 

Inflammation of this membrane is known as pericarditis, of which 
there are several varieties. The function of the heart sac is the 



360 THE NEW MEDICAL WORLD, 

protection of the heart and other organs separating it from those 
which it might otherwise disturb. 

V.— INFLAMMATION OF THE HEART SAC, OR 

PERICARDITIS. 

Pericarditis is an inflammation of the heart sac. It is character- 
ized in general by an effusion of fluid which displaces the heart and 
is liable to be mistaken for pleurisy. The disease may be of a mild 
or violent type. 

CAUSES. 

The causes are somewhat obscure, but are believed to be changes 
of temperature, such as result from taking cold, the inflammation 
of neighboring tissues as in pneumonia and pleurisy, or as secondary 
to some febrile condition, as scarlet fever, or more frequently rheu- 
matism. It is sometimes a complication of B right's disease. 

SYMPTOMS. 

The first symptoms are a chill, followed by fever, accelerated pulse, 
loss of appetite, nausea, vomiting, and pain with tenderness about 
the chest in the region of the heart. The pain may be slight or 
severe. The features usually express an anxious and suffering 
condition. The respiration is labored and attended with a short 
hacking cough. The pulse is weak and irregular. 

After the acute stage is passed, an effusion of fluid takes place in 
the heart sac, sometimes so abundant, as to alter the position of the 
heart. Before the effusion takes place, friction sounds may be heard, 
which are often mistaken for pleurisy, unless the patient holds his 
breath for the listener. After the effusion, the friction sounds dis- 
appear and the natural sounds of the heart are heard with difficulty. 

TREATMENT. 

This is a dangerous disease, liable to be protracted, and requires 
skillful treatment. Exertion should be prevented as far as possible 
and rest maintained. Pain should be relieved by anodynes. When 
there is an excessive quantity of fluid, it may be justifiable to with- 
draw it with an aspirating syringe. This is a delicate operation, and 



THE NEW MEDICAL WORLD. 361 

care must be exercised not to puncture the heart. Stimulants are 
sometimes required in this disease, after the acute symptoms have 
subsided. The carbonate of ammonia answers an excellent purpose. 
It is impossible to map out a definite line of treatment, as the different 
stages of the disease and the varying degrees of its severity require 
a separate treatment for each case. 

In all cases the vitality should be sustained by appropriate nutri- 
ents, as milk, beef tea and other simple food. Physical and mental 
excitement should be avoided by the patient, until recovery has fully 
taken place. 

VI.— VALVULAR DISEASES OF THE HEART, OR 

ENDOCARDITIS. 

The interior surface of the heart is lined by a thin membrane 
which is reflected over the valves and forms their external surfaces. 
The valves of the heart are thin and glistening in health, but in dis- 
ease they become rough, thickened, and lose their shining character. 
Little vegetations may develop on their borders, sometimes as large 
as a pea, and prevent the perfect working of the valves. This 
allows some of the blood to return which has been forced by them. 
In other words, the valves may leak and cause a murmur known 
as mitral insufficiency and aortic regurgitation. 

The principal cause of valvular disease is rheumatism or rheu- 
matic fever. It is sometimes associated with Bright's disease. 

A heart murmur may be caused by anaemia. This is not an 
organic affection. 

Severe attacks of rheumatism may leave the heart valves in such a 
condition as to prevent their perfect closure and permit the blood to 
flow back after it has been forced out. This embarrasses the heart 
and adds to the work it is obliged to perform. 

When the valves leak the heart is compelled to beat faster and 
work harder in order to compensate for the loss. In the same man- 
ner as a pump when it is so out of order that the valves leak you 
must pump harder and longer in order to get a pail of water. The 
increased work which the heart has to do in valvular disease usually 
causes a multiplication of the muscular fibres and an increase of heart 
tissue, which is known as enlargement of the heart or hypertrophy. 

Sometimes instead of increase of the fibres the walls of the heart 
become stretched. This is known as dilitation of the heart, a 



362 THE NEW MEDICAL WORLD. 

process which may extend until the walls become so weakened as to 
rupture. When the valves of the heart are affected recovery may 
take place and no trace of the disease remain, or the affection may 
become chronic, remain stationary, or advance from bad to worse. 

Ulceration of the valves and other chronic changes sometimes 
occur. Ulcerative endocarditis is a severe but fortunately unfre- 
quent affection. 

A mere roughness along the borders of the valves may work mis- 
chief by entangling the fibrin of the blood and forming little clots, 
which may be swept into the circulation and obstruct some dis- 
tant and minute vessel of the brain, kidneys, lungs or other 
organs. When the arterial supply of any portion of the body is thus 
cut off death of the part may result, or an abscess may form or some 
irreparable mischief. 

Thrombosis. — This is the technical designation of a clot which 
forms in the heart, arteries or veins. When it is swept along to 
some distant point and plugs up a vessel it is called in this new 
location an embolus. Should an embolus cut off the circulation of a 
portion of the brain, softening of that portion would soon follow, and 
also paralysis of those parts of the body controlled by that portion of 
the brain. The plugging up of an artery in the lower extremities is 
the cause of gangrene. Embolus of the pulmonary artery may 
cause sudden death. The valves on the left side of the heart are the 
ones most usually affected. 

SYMPTOMS. 

When the valvular affection is slight, the disturbance it causes is 
likely to be slight ; but when it is of a high grade, the disturbances 
are often well marked and accompanied by severe symptoms, as 
labored respiration, anxiety of expression, severe pain, disordered 
digestion and dropsy. When the trouble is with the semilunar 
valves of the aorta pain and difficulty of respiration are prominent 
symptoms. The tendency of such affections is usually progressive. 
Persons often live for years with some defect of the heart valves if 
the amount of regurgitation is small and does not result in the for- 
mation of an embolus or the plugging up of some distant arterial 
canal. 

Pain about the heart is often due to indigestion, and care must be 
taken not to be misled in this direction. The most reliable symptom 



THE NEW MEDICAL WORLD. 363 

in diagnosis is an abnormal sound of the heart or murmur, and yet 
it must be remembered that a murmur may be caused by weakness 
as well as by valvular disease. A constant difficulty in breathing 
may be the most reliable symptom and the one which threatens 
danger. 

TREATMENT. 

Full treatment for all the varying phases of valvular disease could 
hardly be outlined in a condensed work for domestic use. Per- 
sons with valvular disease should avoid excitement or exertion, as 
the climbing of stairs or hills, running, lifting and severe muscular 
exercise. It is perhaps needless to say that ball playing, boat racing 
and similiar efforts of an exciting character should be scrupulously 
avoided. In some cases, where there is a tendency to dropsy, and 
the action of the heart is feeble and irregular, digitalis and caffein 
make a fortunate combination. The following may be used. 

1^ Pulv. digitalis thirty grains 

Caffein forty-five grains 

Mix. Make into thirty pills. 

Dose one before each meal for an adult. 

When tea, coffee or tobacco unfavorably disturb the action of the 
heart, their use should be abandoned. Strychnia, in doses of y-J-g- of 
a grain three times a day, is an excellent tonic for a weak heart. It 
also improves the respiration. 

Dropsy is often troublesome in the last stages of heart disease. 
It causes shortness of breath and marked discomfort when the patient 
attempts to lie down. It begins first with swelling of the ankles and 
its progress is onward, making the demand for skillful attention im- 
perative. 

VII. ANGINA PECTORIS, OR NEURALGIA OF THE 

HEART. 

This is a nervous affection or neuralgia, which comes on suddenly 
and is characterized by intense pain in the region of the heart, 
extending to the left arm. The attacks are attended by alarming 
symptoms, as paroxysmal pain, anxiety and distress. It may be 
brief or last several hours, or the attack may prove fatal. 



364 THE NEW MEDICAL WORLD. 

CAUSES. 

It results from such organic disease of the heart as fatty degenera- 
tion of the muscular fibres, ossification of the aorta or coronary arteries, 
and valvular disease. Gout predisposes to this affection. Sometimes 
it is only a neuralgic affection, there being no organic disease what- 
ever, and in these cases the pain may be due to indigestion or neural- 
gia of the stomach. 

SYMPTOMS. 

The pain attending this affection is spasmodic and peculiarly 
severe. It demands prompt measures for its relief The face is 
pale and anxious, the patient is weak and restless, and feels and 
appears as if death was near. 

TREATMENT. 

A hot mustard plaster of full strength and generous size may be 
placed over the seat of the pain. Ether may be carefully inhaled or 
morphia given by the mouth or hypodermically, and repeated until 
relief is obtained. Three or four drops of nitrite of amyl may be 
inhaled from a handkerchief, and the process frequently repeated. 
Nitro-glycerine in doses of y-i-g- of a grain or the aromatic spirits of 
ammonia in teaspoon ful doses may be given if the action of the 
heart is weak. When attacks recur, caused by gout, the wine of 
colchicum seed in doses of ten or fifteen drops three times a day is a 
remedy of remarkable efficiency. 

VIII.— PALPITATION. 

This is not only a disturbed, but an excited action of the heart 
which may be due to a great variety of causes or to some functional 
or organic trouble. 

When palpitation is functional, it may be due to dyspepsia, to 
anaemia, to some fault in the diet, to intemperate habits, or to some 
disturbed condition of the nervous system. This trouble is fre- 
quently a source of great discomfort to the patient and sometimes 
alarming. It is important in each case to ascertain the cause before 
appropriate treatment can be intelligently employed. In some cases 
nerve tonics, as the phosphate of iron and strychnia, are beneficial. 



THE NEW MEDICAL WORLD. 365 

When due to anaemia, remedies should be used which improve both 
the quality and quantity of the blood. (See anaemia.) 

When this affection results from the use of strong tea, coffee, 
tobacco, alcoholic drinks, or any debilitating habits, their use should be 
discontinued and correct habits vigorously enforced. When palpita- 
tion exists in connection with dyspepsia, outdoor exercise should be 
enjoined, and the diet receive suitable attention. (See indigestion.) 

Palpitation resulting from enlargement of the heart or other 
organic affections demands a line of skillful treatment. 

IX.— VARIOUS OTHER DISEASES OF THE HEART. 

There are quite a number of diseases of the heart in addition to 

those previously mentioned. These diseases are for the most part 

organic, and are of great importance to the medical profession, but 

as they are recognized with difficulty they could hardly be intelligibly 

treated in domestic practice, and for this reason they require only a 

brief notice. 

i 
Hypertrophy or Enlargement of the Heart. — This is usually 

caused by over-action of the heart especially in valvular disease. It 

may result from stenosis of the aorta, from B right's disease, and 

from other obstructions to the circulation, as in some form of lung 

trouble. It is an organic disease of chronic character. 

Mental excitement and physical exertion should be moderated. 
The habitual use of stimulants aggravate this trouble and should be 
avoided. 

Persons who have enlargement of the heart are especially liable to 
apoplexy. 

Fatty Degeneration. — Fatty degeneration of the heart muscle 
occurs from the lack of nutrition, due to various wasting diseases, as 
consumption, scrofula, cancer and others which entail immense 
drain upon the system. It may result from compression of the 
coronary arteries which supply the muscles of the heart with blood. 

There is a change in the structure of the muscles of the heart, and 
fat, more or less, takes the place of the fibre. The heart consequently 
is weak and its contractions feeble, the pulse is weak and irregular. 
The breathing is especially liable to be effected as the result of exer- 
tion. Pain in the region of the heart causes anxiety and failure of 
the heart's action threatens. 



366 THE NEW MEDICAL WORLD. 

Medicine should be used to enrich the blood and improve the 
general condition. The following prescription is appropriate in 
many cases. 

1^, Elix. phosphate iron, quinine and strychnia four ounces 

Dose one teaspoonful in water after each meal. 
In some cases, where a tendency to dropsical effusions exists, the 
following is especially appropriate : 

t^ Pulv. digitalis twenty grains 

Citrate of caffein thirty grains 

Mix. Make into twenty pills or powders. 
Dose one three times a day. 

It is well to emphasize the remark that death may result in these 
cases from some unnatural strain or exertion. 

X.— THE BLOOD VESSELS AND THEIR DISEASES. 

The blood vessels include the arteries, the capillaries and the 
veins. The arteries are strong elastic tubes for the purpose of 
transporting the blood. The large arteries are strong, thick, and 
admit of great strain. They are composed of three coats, an in- 
ternal or serous, a middle or muscular, and an external or cellular. 
The arteries, except those of the cranium, are contained in a loose, 
fibrous sheath. They diminish in size as branches are given off until 
the capillaries are reached. 

The capillaries are very minute vessels, averaging in diameter not 
more than -g^Vo °^ an i ncn - The capillary circulation is very ex- 
tensive and reaches every part of the body, furnishing nutrition 
to all of its organs. The more active the functions of an organ 
the more numerous are the capillaries to supply the increased demand 
for nutrition. 

The veins, as well as the arteries, have three coats, the middle one 
of which is less firm, so that an empty vein falls together, whereas an 
empty artery retains always its circular form. 

Most of the veins are supplied with valves which favor the onward 
movement of the blood toward the heart. 

While the arteries may be attacked by inflammation, dilatation and 
other forms of degeneration, fortunately these diseases are rare. 

Aneurism. — The most frequent affection of the arteries is aneu- 
rism, due to a dilatation of the coats or layers of the vessel. The 



THE NEAV MEDICAL WOULD. 307 

treatment of this affection is for the most part surgical. Aneurism of 
the aorta is beyond the reach of treatment, but those of more super- 
ficial arteries may be cured by ligation, by pressure and other 
appropriate means. 

The rupture of a large internal aneurismal tumor is usually fatal. 
Fatty degeneration of the small arteries of the brain may occur, and 
when these arteries are so weakened as to rupture apoplexy results. 

A calcareous degeneration of the arteries may occur in advanced 
life. In this affection the walls of the arteries lose their elasticity 
and the circular tubes become hard, resembling bone. Such changes 
in the arteries are known as ossification or atheromatous degenera- 
tion. 

Most of the affections of the blood vessels are due to injury, 
old age, the action of alcohol or the result of syphilis. (See chronic 
alcoholism.) 

Varicose Veins. — The most common affection of the veins is due 
to their dilatation and to the breaking down or rupture of the valves. 
This condition occurs frequently in the veins of the lower extremities, 
and is known as varicose Veins. This condition may be caused by any 
occupation which requires standing constantly upon the feet. Child- 
bearing, however, is the most frequent cause. Chronic constipation 
may be regarded as a factor of some importance in the production of 
this trouble. 

From varicose veins may result swelling of the limbs, ulceration 
and hemorrhage. 

The affected limb is purple about the ankle, shin or under the 
knee, the discoloration extending upward sometimes to the thigh, 
involving more or less extent, according to the severity of the case. 
The veins are distended, more or less twisted and knotted, and give 
to the limb a characteristic discoloration. 

Varicose veins require external pressure and support by means of 
bandages or the elastic stocking. Rest and elevation of the limb 
favors the circulation, especially if the limb is raised higher than the 
head while in a reclining position. 



CHAPTER XXII. 

THE INTESTINES, RECTUM AND THEIR 

DISEASES. 



I. — The Small Intestine. II. — The Large Intestine. III. — 
Diseases of the Rectum. 1. Congenital Deformity. 
2. Injuries of the Rectum. 3. Fissure and Ulcer. 
4. Rectal Abscesses and Fistula. 5. Itching about 
the Anus or Pruritis. 6. Piles or Hemorrhoids. 7. Pro- 
lapse of the Rectum. 8. Polypi, IV. — Other Rectal 
Affections. 1. Stricture. 2. Cancer. V. — Rectal 
Alimentation. VI. — Intestinal Catarrh. VII. — Dys- 
entery. VIII. — Cholera Morbus. IX. — Cholera, Asi- 
atic. X. — Inflammation of the Bowels, Obstruction 
and Appendicitis. XI. — Hernia. XII. — Peritonitis. 
XIII.— Colic. XIV.— Constipation. XV.— Worms. 

I.— THE SMALL IXTESTIXE. 

THE small intestine is a circular canal about twenty feet in length 
and leading from the stomach to the ileo-caecal valve, where it 
joins the colon. It is folded upon itself and held in place by folds of 
the omentum. Its situation is within the abdominal cavity. 

The small intestine is divided into three portions, the duodenum, 
the jejunum and ileum. The duodenum is the first portion and 
receives the contents of the stomach as they pass out from the 
pyloric orifice. The pancreatic duct and the common bile duct open 
into the small intestine three or four inches from its beginning. 
The small intestine is composed of four coats or layers. The 
muscular coat contains two layers of fibers, one taking a longitudinal 
and the other a circular direction. The mucous or internal layer 
contains numerous glands which open upon the surface and which 



THE NEW MEDICAL WORLD. 369 

secrete fluids abundantly to aid in completing the process of diges- 
tion. This process is complicated in the small intestine, for the 
reason that a variety of work is going on at the same time, as, 
for instance, the process of absorption, which is simultaneous with 
digestion. 

The absorbent vessels take up and cany away the material which 
has been digested and changed into chyle. It is carried and poured 
into the circulation, and by the time the contents of the bowels have 
reached the colon both the process of digestion and absorption 
have thoroughly taken place. 

In order to understand the process of absorption it is necessary to 
know that the small intestine is covered over on the inside surface by 
numerous little elevations, called villi, which give it a velvety ap- 
pearance. These villi are very numerous, being estimated in each 
individual as several millions. They are the agents which carry on 
the work of absorption. They project out into the nutritious fluids 
and semi-fluids contained in the intestine very much as the roots 
of a tree permeate the soil. They drink into little microscopical 
mouths in a rapid and thorough manner the liquids prepared for 
their use. The process of absorption takes place throughout the 
entire length of the small intestine. The vermicular motion of the 
bowel serving to bring these little hungry and thirsty absorbents into 
contact with the contents of the intestine, so that nearly everything 
suitable to be taken into the circulation is appropriated, while the 
food is slowl} T passing from the stomach to the large intestine. The 
villi contain arteries, veins and lymphatic vessels, called lacteals, all 
of which are more or less engaged in the process of absorption. 

It is interesting to follow the course of this nutritious material 
taken up from the small intestine and see how it is able to reach the 
general circulation. 

That portion absorbed by the blood vessels is carried directly to 
the liver by means of the portal vein, where it is prepared to pass 
into the general circulation. 

That portion absorbed by the lacteals is turned into the thoracic 
duct and passes onward to the left subclavian vein, where it flows 
into the venous blood current and mingles with it. Changes are 
constantly taking place in this nutritious fluid, so that by the time it 
has reached the lungs, it is simply rich blood and all traces of its 
previous character have disappeared. In this interesting manner the 
blood is constantly supplied with new and rich material from the 



370 



THE NEW MEDICAL WORLD. 



food. The tissues of the body are rebuilt daily to some extent and 
destructive wastes are compensated for by the reception of new 
elements. 




, ,,-..«,. 6 r 

p v 

n ! ^-^dS^ - 

WSM 

o 

The digestive apparatus : A, oesophagus ; b, stomach ; c, cardiac extremity ; d, pyloric 
extremity of the stomach; e, gall bladder ; f , duodenum ; g, lower end of small intestine ; 
h, ileo-caecal valve ; i, vermiform appendix ; j, ascending colon ; k, transverse colon ; 1, 
descending colon ; m, sigmoid flexure or S-shaped flexure of the c, Ion ; n, rectum ; o, arms 



II.— THE LARGE INTESTINE. 

The large intestine begins at the termination ot the ileum and 
extends to the anus. Its length is about five feet and its diameter is 
considerably larger than the small intestine. 

The three names given to the different portions of it are the caecum, 
colon and rectum. The csecum is the beginning of the large intestine 
and is situated at the right and lower parts of the abdomen. Attached 
to it is the vermiform appendix, a small tube three or four inches in 



THE NEW MEDICAL WORLD. 871 

length and about a quarter of an inch in diameter. This is sometimes 
the seat of acute and chronic inflammatory action. It is a rudimen- 
tary sac and in man has no necessary use. (See appendicitis.) 

From the caecum the large intestine extends upward on the right 
side as far as the liver, then transversely across the abdomen then 
down on the left side. These portions are also known as the ascen- 
ding the transverse and descending colon. The entrance of the ileum 
into the caBcum is known as the ileo-crecal valve. The descending 
colon terminates in the portion known as the rectum, and owing to a 
curve at this point resembling the letter S, it is called the sigmoid 
flexure. The large intestine is retained in position by folds of the 
peritoneum. Its termination is the rectum which extends from the 
sigmoid flexure to the anus. As the rectum approaches the anus, it 
is more or less dilated in order to hold the accumulating contents of 
the bowel at this point. The large, like the small intestine, has 
four layers. The internal surface of the mucous layer is not covered 
with absorbent villi but merely lodges some simple follicles and 
glands. The rectal portion of the large intestine is subject to so 
many annoying affections as to deseiwe some special attention. 

The outlet of the rectum is guarded by two circular or sphincter 
muscles under the control of the will ; the internal sphincter being 
about an inch above the outlet while the external sphincter puckers 
the outlet like a purse string. Paralysis of the sphincter muscles 
though infrequent occasions much annoyance. 

III.— DISEASES OF THE RECTUM. 

Congenital Deformity. — There is sometimes the abscence of a 
rectal outlet or other congenital deformity. When a child is born 
with this defect death soon occurs unless relief is afforded by skillful 
surgery. Such deformities, if not too extensive, may often be com- 
pletely relieved. The necessity for relief, however, should be recog- 
nized promptly, as delay might thwart the most skillful operation. 

The number of children born with some deformity is large in the 
aggregate, those of the mouth and rectum being among the most fre- 
quent and important. 

Injuries of the Rectum. — Injuries of the rectum may occur from 
falls or accidents, as in severe labor. From such injuries hemorrhage 
is usually profuse, but they generally heal kindly if the parts are 
thoroughly cleansed and properly treated. A good result is not 



372 THE NEW MEDICAL WORLD. 

likely to be obtained if constipation is permitted, as a difficult move- 
ment reopens the lacerated surfaces and prevents healing by first in- 
tention. 

Fissure and Ulcer. — A fissure of the rectum is an irritable ulcer 
in which healing is hindered by its location and the spasmodic action 
of the external sphincter muscle. It is caused usually by a little 
rent or tear in the margin of the anus. The rectum is especially 
liable to irritation and injury from the passage of hard fseeal matter 
owing to the wide prevalence of constipation. It is chiefly owing to 
neglect that the rectum is so frequently affected by a large number of 
annoying diseases. A little rent or fissure if not properly treated, 
may exist for years and cause unlimited distress and suffering. It 
is attended by a disagreeable smarting sensation which is augmented 
by every movement of the bowels. The general health suffers, the 
patient is sallow and wears an expression indicative of prolonged 
suffering. This affection so trifling in itself is sometimes so painful 
as to be mistaken for a cancer. 

Treatment. — The treatment, fortunately, is both simple and suc- 
cessful. At first laxatives should be administered as an ounce or two 
of castor oil or a generous dose of Epsom salts. The ulcer should next 
be washed over with a solution of nitrate of silver, ten grains to the 
ounce of water. This stimulates the ulcer and brings about a healthy 
condition of the surrounding tissue. It may then be dressed with 
benzoated oxide of zinc ointment or an ointment containing a dram 
of iodoform mixed with an ounce of vaseline. This method of 
treatment is suitable for any ulcer or fissure of the rectum about the 
margin of the anus. 

When there is agonizing pain caused by the spasmodic action of 
the sphincter muscles, these measures alone will not be sufficient, but 
the patient should be put under an anaesthetic, and then the muscle 
should be partially or wholly cut through or stretched until its fibers 
are sufficiently lacerated to prevent future contraction or spasm, after 
which it can be healed as readily as if it existed in any other location. 

Rectal Abscesses and Fistula. — The tissue about the anus is a 
frequent site for the development of an abscess which is frequently 
followed by a fistulous track leading from the rectum to the ex- 
ternal surface in the neighboring vicinity. 

The management of a rectal abscess differs only slightly from 
a similar affection elsewhere. A thorough incision is necessary to 



THE NEW MEDICAL WORLD. 373 

liberate the pus, and the after treatment consists in keeping the 
abscess cavity clean and healing it from the bottom. Rest in bed is 
recommended and soothing applications, as a warm poultice covered 
w 7 ith laudanum. 

A fistula usually has an external and an internal opening ; the ex- 
ternal is outside the anus and the internal is within the rectum, just 
above the sphincter muscle. The internal opening may be difficult to 
find. There are a few other causes beside the one already mentioned 
w r hich may result in a fistula, as a fish bone, a pin or other foreign 
body which may become lodged above the sphincter muscle and 
ulcerate through to the external surface. 

A fistula does not tend to heal of its own accord, but produces 
much uneasiness, disagreeable itching and pain. It is usually a 
source of no little annoyance. 

Treatment. — The treatment is chiefly surgical, and usually re- 
quires a complete division of the tissue from the fistula into the 
rectum, cutting completely through the sphincter muscle. Re- 
covery then takes place rapidly, and healing from the bottom of the 
wound goes on without interruption from spasm of the divided 
muscle. After the operation the wound should be cleansed each 
day and a little iodoform of aristol sprinkled between the surfaces. 
Other operations suggested for the treatment of a fistula have not 
yielded as satisfactory results as the one already detailed. 

Itching of the Anus or Pruritus. — This is sometimes a disa- 
greeable, obstinate and painful affection, which is usually worse at 
night. 

There is often an excess of moisture about the rectal orifice, and 
unless removed by frequent bathing it is highly irritable, and the 
trouble is much increased if the inclination to rub or scratch 
is yielded to. 

The causes are quite indefinite and perhaps numerous as high 
living, sedentary habits, overwork, irritating perspiration, eruptions, 
piles, eczema, seat worms and derangement of the nerve forces. 

Why such causes should occasion pruritus in one and not in 
another is puzzling, and it may be doubted whether there is much 
connection between some of the causes recounted and the disease 
beyond the fact that some explanation must be offered for such 
a troublesome affection. 



374 THE NEW MEDICAL AV0RLD. 

Treatment. — The treatment is simplified when the cause of the 
affection is known with certainty. Bathing the affected locality 
daily with warm or carbolized water is beneficial. The application 
of benzoated oxide of zinc ointment, to which a little chloroform 
may be added, is recommended by competent authorities. The appli- 
cation of alcohol when it can be borne is said to be of service. The 
following may be used each night at bed time, and if necessary 
in the morning. 

5, Carbolic acid twenty grains 

Cocaine ten grains 

Menthol thirty grains 

Oxide of zinc ointment one or two ounces 

Mix. Use externally. 

If the patient is debilitated and suffering from nervous disorders 
the following in addition is suggested for internal treatment. 

t^ Fowler's solution one and a half drams 

Elix. calisayaa four ounces 

Mix. Dose one teaspoonful three times a day after meals. 

Piles or Hemorrhoids. — Piles are a very common affection. In 
fact, there is no other disease of this region so frequent. There 
are two varieties, external and internal. 

External piles are little tumors at or near the margin of the anus. 
Internal piles are little tumors within the orifice which are liable to 
become inflamed, bleed and protrude. The causes as commonly 
enumerated are constipation, long continued sedentary habits, irritat- 
ing physic, high living, pregnancy or any obstruction of the pelvic 
circulation. 

Piles are, in reality, little blood tumors or dilitations of pelvic 
blood-vessels and are chiefly caused by irritation of the anus and the 
obstruction of the venous circulation. 

Internal piles are often painful, liable to bleed and to protrude as 
the result of straining at stool. 

Treatment. — Rest, cold applications, astringent ointments or 
anodyne and astringent suppositories are appropriate. External 
piles can be permanently cured by making an incision into the little 
tumor and turning out its contents which is a clot of blood. Inter- 
nal piles may be permanently cured by ligation. 

Palliative treatment may afford relief for a long time. The diet 
should be regulated and constipation carefully avoided. The injection 



THE NEW MEDICAL WORLD. 375 

of a pint of warm water into the rectum before each stool affords 
considerable relief. 

The following prescription is unrivaled. 

I£ Pulv. opium six grains 

Ext. hyoscyamus six grains 

Ext. belladonna three grains 

Tannin twelve grains 

Cocaine six grains 

Cacao butter q. s. to make twelve suppositories 
Insert one well into the rectum each night and morning. 

Prolapse of the Rectum. — This is a protrusion of a ring of mucous 
membrane outside of the anus. It sometimes happens that several 
inches of the entire rectum is forced outside the external sphincter. 

This affection in a mild form is common in young children in 
a debilitated condition. The immediate cause of this affection is 
relaxation of the sphincter muscle, irritation of the urinary organs, 
rectal irritation from worms, dysentery or constipation. 

Prolapse of the rectum rarely happens in middle life except as the 
result of piles, but it frequently happens in very young children 
or very old people as the result of weakness and debility. 

Treatment. — The protruding bowel should be returned. Place 
the patient in a recumbent position. Oil the fingers and gently push 
back the protrusion. The utmost gentleness should be used to 
avoid resistance which will increase the difficulty of reduction. 
Having replaced the prolapsed tissue a repetition of its descent may 
be prevented by a pad held in place with a bandage. The appli- 
cation of astringent washes may be necessary to prevent a return 
of the trouble. Constipation must be avoided and straining at stool. 

Polypi. — A polypus within the rectum should be treated the same 
as in any other locality by removal. 

IV.— OTHER PvECTAL AFFECTIONS. 

Stricture. — There are a number of other rare affections of the 
rectum. Stricture may result from some inflammatory process, as 
extensive ulcerations, syphilitic diseases and cancer. The diameter 
of the rectum is much reduced, and at length complete obstruction 
may result. The approach of this affection is often unrecognized. 



376 THE NEW MEDICAL WORLD. 

The treatment consists in dilating the stricture by mechanical means, 
using a bougie or sponge tents. The latter method is considered 
the safer. 

Cancer. — Cancer of the rectum is not a frequent disease. When 
it exists it is very painful and likely to terminate life. The causes 
are unknown. The prominent symptoms are pain, the dischage of 
blood and pus, constipation, sallow complexion, loss of strength, 
more or less obstruction, and finally exhaustion. When ulceration 
takes place with a breaking down of the tissues the discharge is very 
offensive. 

Treatment. — When the disease is discovered early its entire 
removal may be accomplished and afford a good chance for a cure. 
When it has so progressed that removal is impossible palliative rem- 
edies are alone required. (See cancer.) 

The old method of using paper with printer's ink upon it, or 
other harsh or unsuitable substances for toilet purposes was doubtless 
the cause of much irritation of the anus if not the actual cause of dis- 
ease. The modern use of soft tissue is a much needed improvement 
and in the interest of better health. 

V.— RECTAL ALIMENTATION. 

The rectum has some ability to absorb, not only medicines which 
may be applied to it locally, but also nutrients. Life has been main- 
tained for several consecutive weeks by the use of nutritive enemata. 
This fact is borne in mind by physicians who, not only relieve pain 
successfully by the use of suppositories, but when the stomach is 
disabled, resort to rectal feeding with satisfactory results. 

VL— INTESTINAL CATARRH. 

Since the intestines are lined throughout with mucous membrane 
containing a vast number of mucous glands, any portion may become 
the site of a catarrhal inflammation. Different names are given to 
this disease, and different symptoms are manifested depending upon 
the portion of this canal which is involved. A catarrh of the duo- 
denum is likely to obstruct the outlet of the bile duct and occasion 
jaundice, a condition liable to be mistaken for some disorder of the 
liver. The two most prominent causes of intestinal catarrh are 
changes of temperature and improper diet. 



THE NEW MEDICAL WORLD. 377 

Among the various symptoms the following may be mentioned. 
Disordered digestion, nausea, vomiting, diarrhoea, pain and lastly 
jaundice if the site of the trouble is in the duodenum. Other symp- 
toms may appear such as a coated tongue, fetid breath, headache, 
languor and a yellow condition noticed in the whites of the eyes. 

TREATMENT. 

This consists in regulating the diet, offending material may be 
removed by a dose of oil or other mild laxative. The following 
prescription may be used in these cases to advantage : 

r£ Castor oil one half ounce 

Paregoric two drams 

Syr. acacia one ounce 

Cinnamon water one ounce 

Mix. Dose one teaspoonful every four hours for a child one 
year old, adults in proportion. 

Intestinal catarrh, especially of the ileum and colon, may terminate 
in cholera infantum when the patient is only several months old 
if the weather is hot. In such cases the stools are first slimy and 
often green in color and their passage attended with griping pain or 
colic. The patient gets thin rapidly, the heart is weak and the urine 
highly colored. This disease may become chronic and exist for a long 
time without the development of cholera infantum. Such cases 
usually recover after the heat of the summer is over. 

In adults this persistent looseness of the bowels is known as 
chronic diarrhoea. It was a troublesome affection in the army. 

For children chalk mixture and bismuth combined, are excellent 
remedies. 

^, Salicylate of bismuth one dram 

Chalk mixture two ounces 

Paregoric two drams 

Syr. acacia q. s. to make three ounces 

Mix. Dose one teaspoonful every four hours for a child two years 
old. 

For the chronic diarrhoea of adults the following is efficient: 

^, Tinct. opium deodorized four drams 

Fowler's solution one dram 

Wine of blackberry root q. s. to make four ounces 
Mix. Dose one teaspoonful every four hours. 



378 THE NEW MEDICAL WORLD. 

VII.— DYSENTERY. 

Dysentery is a disease of the mucous membrane which lines the 
large intestine. There is ulceration of this tissue attended by griping 
pain and the discharge of mucous, blood and pus. It may exist in 
any climate but is more prevalent in the hot season. 

CAUSES. 

Climate may be considered the most promiment cause. It prevails 
especially in July, August and September. Heat, moisture and atmos- 
pheric changes are a combination which favor its development and 
prevalence. The decomposition of animal and vegetable matter 
during hot weather are favorable to its appearance. Among other 
causes unsuitable articles of food, the fermentation of food and the 
impurities of drinking water deserve mention. It is common among 
prisoners of war, especially when they are confined to a coarse diet 
without vegetables or fruit. It is sometimes epidemic and some have 
favored the opinion that it was caused by a specific germ of which 
proof is wanting. If it can be proved that dysentery is contagious, 
then its germ origin becomes positively established. 

SYMPTOMS. 

These are intestinal catarrh, abdominal tenderness, peculiar twisting 
pains, colic and an urgent desire for the stool, straining, smarting 
and inability to leave the stool or a desire to return almost immedi- 
ately. There may be from twenty to forty or more movements of 
the bowels in twenty-four hours. The discharges are scant containing 
strings of mucous tinged with blood. From this fact it is sometimes 
called bloody flux. Emaciation is rapid and the patient, if not 
relieved, soon enters upon a typhoid condition. 

TREATMENT. 

Rest in the reclining position is important and ought to be insisted 
upon. In a mild case a dose of castor oil may be given to relieve the 
bowels of offending matter before they are put to rest with anodynes. 
A pint of warm water or starch water containing twenty or thirty 
drops of laudanum and a pinch of pulverized alum may be thrown 
into the rectum with a syringe. Medicines introduced into the 



THE NEW MEDICAL WORLD. 379 

rectum have a local effect and are often much more efficient than 
when given by the mouth. A single astringent injection often com- 
pletely changes the character of the disease. In severe cases a half 
dram of nitrate of silver dissolved in a pint of water and injected into 
the rectum w r ith a syringe w r ill produce surprising results. The 
syrup of acacia and a little laudanum may be added with advantage. 
The injection affords more relief if used cold, or nearly so, and 
may be repeated in two or four hours. Ipecac, is much lauded 
as a specific for dysentery. 

Boiled milk is an excellent article of diet for these cases. Raw, 
chopped beef and soft boiled eggs may be used. In bad cases stimu- 
lants maybe essential. 

When for any reason the use of the injections are inconvenient 
suppositories may be used instead as the following : 

^ Ext. witch-hazel thirty grains 

Cocaine . three grains 

_ 9 

lannin twelve grains 

Pulv. opium twelve grains 

Cacao butter 4. s. to make twelve suppositories 

One of these may be pushed well into the rectum each night and 
morning. The cocaine in the above perscription causes the griping 
pain to disappear and the patient gets refreshing sleep, which is 
so much needed. 

When the disease can be traced to a malarial origin, as is sometimes 
the case, the following is appropriate and will give satisfaction. 

I£ Salol one-half dram 

Quinine two scruples 

Morphine three grains 

Mix. Make into twenty pills, or put into capsules. 

Dose one three or four times a day for an adult in addition to the 
other treatment recommended. 

Ulceration of the bowels, it is to be remembered, is one of the 
conditions common to dysentery, and the above treatment is suitable 
for all such cases. 

VIII.— CHOLERA MORBUS. 

Cholera morbus is sometimes called sporadic cholera. It resembles 
true Asiatic cholera except that it is usually less severe and less liable 



380 THE NEW MEDICAL WORLD. 

to terminate fatally. It occurs in the hot weather of summer or in 
the autumn when hot days are followed by cool nights. 

CAUSES. 

It appears to result from a combination of causes, among 
which heat and indigestible food are prominent. Wilted vegetables, 
unripe fruits, articles of diet which favor fermentation and the exces- 
sive use of ice water seem favorable to its development. Sudden 
changes of temperature, and sudden checking of the perspiration 
are among the factors which may be mentioned as causative. 

SYMPTOMS. 

The attack usually comes on suddenly with nausea, vomiting, 
chilly sensations, colicky pain in the bowels and diarrhoea. Vomiting 
affords only temporary relief, and after the stomach is emptied of its 
contents, the vomiting continues at intervals with increasing distress. 
After the contents of the stomach are expelled, the vomited matter 
is yellow or greenish in color, leaves a bitter taste in the mouth and 
is mixed with a large amount of mucous. When vomiting continues 
long enough, these bilious secretions are succeeded by a thin 
fluid having the characteristic appearance of rice water. A similar 
fluid is passed by the bowels. 

When the pain and diarrhoea are not promptly relieved, all the 
symptoms are aggravated ; the patient becomes cold and clammy, 
cramps occur in the stomach and in the muscles of the arms and legs; 
there is great thirst, the heart's action wanes, the pulse becomes weak 
and thready, the sufferer appears exhausted, losing strength rapidly 
but cannot rest for a moment as the pain and suffering increase. A 
condition of pallor and prostration ensue which is known as col- 
lapse. 

All cases are not thus severe because they are not permitted to 
reach the stage just mentioned. In mild cases as soon as the 
stomach and bowels are unloaded relief is sometimes experienced and 
recovery takes place rapidly. 

TREATMENT. 

A generous mustard poultice strong enough to redden the surface 
without blistering should be placed over the stomach and bowels. 



THE NEW MEDICAL WORLD. 381 

When the thirst is excessive little fragments of ice may be used 
to allay it, or lemonade or bread coffee, well cooled, may be permitted 
for the same purpose. Small doses of aromatic sulphuric acid 
and tincture of opium may be given in camphor water to check 
the diarrhoea as follows : 

1^ Aromatic sulphuric acid one dram 

Tinct. of opium one and a half drams 

Camphor water four ounces 

Mix. Dose a teaspoonful every hour as needed. 

When marked prostration and continued vomiting take place 
iced brandy frequently repeated is beneficial. The following pre- 
scription will work well in mild cases if taken early, 

3 Aromatic spirits of ammonia one dram 

Paregoric four drams 

Magnesia one dram 

Peppermint water q. s. to make four ounces 

Mix. Dose one tablespoonful every hour or half hour. 

No method of treatment affords so much satisfaction to the physi- 
cian as the hypodermic injection of morphia combined with atropia. 
It quiets the vomiting, eases the pain and brings about hasty 
reaction which is soon observed. The pulse improves, the warmth 
of the body is restored, cramps subside, diarrhoea ceases, the patient 
rests and is better. When the patient is not relieved within an hour, 
the dose which is one quarter of a grain of morphia and T i^ of a 
grain of atropia may be repeated. 

The diet should be simple for several days after recovery to prevent 
a relapse. In some cases complete recovery is retarded and such 
demand tonics or perhaps medicines to stimulate the action of the 
liver or the kidneys or both. 

IX.— CHOLERA, ASIATIC. 

This dreaded disease is not common in the United States, but is 
liable to be brought into our sea-ports and large cities. In 1832 the 
cholera visited New York City, and there were three thousand five 
hundred and thirteen fatal cases. It has raged in nearly all sections 
of the old world at various times, destroying multitudes of people or 
devastating large armies. It has existed in India from a very remote 
period, and from thence it has appeared to spread to other sections 
of the world. 



382 THE NEW MEDICAL WORLD. 

CAUSES. 

Cholera is caused by an extremely minute specific disease germ,, 
which enters the human system in various ways. The spread of 
cholera is favored by over-crowding, poverty, intemperance, high 
temperature, unfavorable surroundings or vicious and unclean 
habits. 

These do not originate cholera, but are favorable for its develop- 
ment. Water is, undoubtedly, the most effectual agent in spreading 
the disease when it contains the cholera germs. 

SYMPTOMS. 

In a very short time after the contagion is received into the system, 
profuse diarrhoea occurs with liquid stools, causing little or no pain, 
but followed by great prostration. This symptom intensities, the 
stools take on the characteristic rice-water appearance, vomiting 
occurs, and if the attack is severe, cramps in the muscles of the 
legs, followed by pallor, chilliness, thirst, weakness and collapse. 
There is a marked decline in the bodily temperature, the patient sinks 
rapidly, the contenance appears pinched and shrunken with a leaden 
hue ; the breathing becomes difficult, the pulse weak, the surface of 
the body cold and bathed with a damp perspiration ; the fingers and 
face get blue and the voice weak and sepulchral. Reaction sometimes 
takes place even after the manifestation of all these symptoms, but 
death is more common and occurs in about twelve hours. 

TREATMENT. 

No treatment has ever been universally successful. About fifty 
per cent, of all cases die. When cholera is epidemic, no case of 
diarrhoea should be neglected or allowed to take its own course. 

Nothing can render more prompt and certain relief, than the 
hypodermic injection of morphia with atropia. (Morphia one fourth 
grain atropia T i^ and repeat as circumstances require.) 

Excellent results have been claimed from the use of the following : 

5, Aromat. sulph. acid one ounce 

Tinct. opium one ounce 

Mix. Dose fifteen to thirty drops every hour. 



THE NEW MEDICAL WORLD. 383 

Mustard poultices over the stomach favor reaction and often 
prevent vomiting. Pieces of ice may be given for the thirst or iced 
brandy may be used. The following is excellent : 

I£ Carbolic acid lifteen drops 

Tinct. of camphor two drams 

Spirits of chloroform four drams 

Peppermint water q. s. to make two ounces 

Mix. Dose one teaspoonful in water repeated every hour or haif 

hour. 

The diet must receive attention. Boiled milk, wheat gruel with 
milk boiled into it, mutton or beef broth and even raw or soft cooked 
eggs may be used. 

Sometimes collapse and death occur so suddenly that very little 
can be done. Cholera is especially fatal to alcoholic drinkers. 

X.— INFLAMMATION OF THE BOWELS, OBSTRUCTION 

AND APPENDICITIS. 

Inflammation of the bowels may result from various causes. Any 
obstruction, if not soon relieved, develops inflammatory action, 
except the obstruction is partial, as from a growth or cancer. In- 
flammation may take place in any portion of the intestinal canal and 
the symptoms will vary somewhat with the portion affected. 

Obstruction. — Obstruction of the bowels is sometimes caused by a 
strangulated hernia, by bands of fibrous tissue, or by the twisting of 
the bowel upon itself in such a way as to prevent the passage of its 
contents. At the junction of the ileum and colon the bowel may 
become obstructed by its fiecal contents. Habitual constipation 
may cause some of these difficulties, but on the whole fatal diseases of 
the bowels are less common than might be expected. 

The symptoms are severe pain, similar to colic, impeded respira- 
tion, anxious expression, a cold sweat upon the brow, enlarged 
abdomen, vomiting of faecal matter, and in desperate cases persistent 
hiccough. 

Diseases of the intestines are so painful and dangerous that it is 
not customary to rely upon any course of domestic treatment for 
their alleviation. In some of these diseases the symptoms are too 
obscure to render their description intelligible or their treatment 
safe. The treatment in all these cases should be outlined in accord 



384 



THE NEW MEDICAL WORLD. 



with the symptoms. Suitable directions for adequate treatment can- 
not be detailed in advance. 

In a general way it may be said that diseases of the bowels require 
rest in bed. Constipation should be relieved either by laxatives or 
rectal injections. A hot poultice placed over the abdomen in some 
cases affords a measure of relief. Cold acid drinks, as lemonade and 
cream of tartar, are excellent to relieve the thirst. 

Appendicitis. — This is a dangerous affection which may be caused 
by the lodgement of a foreign body as a grape seed, a prune stone, a 
cherry pit, a gall stone or hardened feces in the vermiform apj)endix. 
Many cases, however, cannot be traced to such a cause but appear to 




The caecum and colon opened and front portion removed to show the ileo-caecal valve : 
a, ascending colon ; b, ileo-cascal valve ; c, opening into vermiform appendix ; d, termina- 
tion of appendix ; e, small intestine. 

be due to obstruction of the arterial circulation in the appendix or to 
local catarrhal or inflammatory action. If the blood supply is entirely 
obstructed or cut off, death of the part or gangrene results. When 
a foreign body becomes impacted, or local inflammation takes place 
in the appendix, suppuration and perforation are liable to occur. 



THE NEW MEDICAL WORLD. 885 

When pus or fsecal matter pass through a perforation into the abdomi- 
nal cavity, they cause fatal peritonitis. An abscess sometimes forms 
outside but in the vicinity of the appendix, which, if left to itself, 
will rupture into the abdomen, or in occasional cases it may work 
its way to the surface through the external abdominal walls. 

SYMPTOMS. 

The symptoms of appendicitis are similar to those of general 
inflammation of the bowels, for which in the past it appears to have 
been many times mistaken. The chief symptoms are tenderness upon 
pressure on the right side in front of the haunch bone accompanied 
with pain more or less severe. Sometimes the tenderness and pain 
are complained of as high up as the pit of the stomach and very 
commonly about the umbilicus or navel. Other symptoms are nausea, 
vomiting, loss of appetite, coated tongue, restlessness, fever and an 
anxious expression. Should pus be forming in or about the appendix, 
chills are likely to take place. 

TREATMENT. 

Before inflammation has developed, the sulphate of magnesia may 
be given in teaspoonful doses and repeated every hour or two. This 
remedy liquefies the contents of the bowels, relieves congestion and 
is not likely to be vomited or do harm. Warm water injections may 
be gently thrown into the rectum and colon by means of a syringe 
in the early stages of the affection. 

More cases are relieved and cured by surgical interference than by 
any other method, and a disease of such grave import should have 
the benefit of early and skillful attendance. 

Inflammation in the neighboring tissues of the appendix has been 
called typhlitis and perityphlitis. These terms are used much less 
than formerly, since appendicitis has come to be more fully recognized. 

Hemorrhage of* the bowels is a common occurrence in ulceration, 
dysentery and other acute affections, and is sufficiently noticed in 
connection with the acute diseases, which see. 

XL— HERNIA, BREECH OR RUPTURE. 

Hernia is a protrusion of a loup of intestine or other tissue 
through the internal coverings of the abdominal wall. It is not 



386 THE NEW MEDICAL WORLD. 

commonly a rupture of these tissues, but the hernia follows some 
one of the natural openings which exist in the inguinal or femoral 
regions or at the umbilicus. 

Inguinal hernia is the most frequent variety, it being eight times as 
common as femoral, and femoral being twice as frequent as umbilical. 
Other forms of hernia are too rare to receive attention except in an 
exhaustive treatise. 

SYMPTOMS. 

The symptoms of hernia are a peculiar fullness as of a bunch or 
tumor whose size is increased by standing or by the act of coughing. 
There may be considerable pain, nausea, vomiting and a feeling 
of weakness or prostration. 

A hernia is reducible when it goes back of itself or with the as- 
sistance of manipulation. When it cannot be put back it is irreduci- 
ble. When the circulation becomes much obstructed in a hernia it is 
known as strangulated. 

TREATMENT. 

The horizontal position should be assumed with the limbs drawn 
up and the head placed lower than the feet or body. This position is 
favorable to the reduction of the hernia, or it may go back itself 
without assistance. Chloroform or ether carefully inhaled at the 
hands of a competent medical attendant favors reduction. The same 
may be observed with respect to the hypodermic use of morphia. 

For the treatment of congenital hernia, use a suitably adjusted 
truss which rarely fails to cure. 

The manipulation used to replace a hernia is called taxis. It. 
should not be continued too long, neither should too much force be 
employed. Taxis is an attempt to push the hernia back with the 
fingers, little by little, through the opening. A knowledge of the 
direction by which the hernia has advanced is very helpful and almost 
essential to its employment. In the hands of a competent surgeon 
taxis is much favored by the application of cold or a piece of cotton 
saturated with ether. 

A strangulated hernia should receive attention without delay, as 
the condition is critical and constantly becomes more so. A hernia 
which cannot be reduced by simple means demands immediate and 
skillful attention, an operation being frequently required for its- 
reduction. 



THE NEW MEDICAL WORLD. 387 

XII.— PERITONITIS. 

Acute peritonitis is an inflammatory disease of a serious character. 
It may be local and confined to a single part or general, extending 
throughout the abdominal cavity and the organs which are covered 
by the peritoneum. 

CAUSES. 

These are a cold or injuries sufficient to excite an inflammatory 
process. Peritonitis follows perforation of the stomach, perforation 
of the bowels, rupture of the liver, the rupture of an abscess or 
hemorrhage into the abdominal cavity. It is often the result of the 
extension of some inflammatory process, beginning in one of the 
pelvic organs. It may follow abortion or childbirth. It results 
sometimes from gonorrhoea in the female. 

SYMPTOMS. 

Sometimes it is ushered in b}^ a chill followed by hio;h fever and 
rapid pulse. If from perforation of the bowels, the onset is sud- 
den and presents the symptoms of nervous shock, with faintness, 
clammy skin, perspiration and collapse. 

The most prominent symptom is usually pain with great tenderness 
and distension of the abdomen. The pain is so peculiar and cutting 
that the patient is unable to bear the weight of the bedclothino- or of 
the hand or finger. The patient lies upon the back and avoids mov- 
ing, with the lower limbs drawn up to relieve the tension of the 
abdominal muscles. The breathing to avoid motion of the dia- 
phragm, is short, shallow and rapid, also the countenance is anxious. 
The pulse is quick, reaching a hundred and forty or more. Nausea 
and vomiting may occur, and there maybe diarrhoea or constipation. 

Hiccough is often annoying, especially toward the close of the 
attack, and it is associated with other symptoms of prostration, 
When peritonitis is due to perforation of the bowels the mortality is 
great. 

TREATMENT. 

The responsibility of treating a case of peritonitis is so great and 
the issues are so uncertain that in every instance a trusted physician 
should be employed. 



388 THE NEW MEDICAL WORLD. 

There has been much progress made in the treatment of this 
disease, for in former times nearly every case proved fatal. It was 
due to the efforts of Dr. Alonzo Clark that the disease became 
manageable and in a large per cent, of cases curable. The one remedy 
upon which he relied was opium in sufficient quantity to entirely 
relieve the pain. The preferable method of administration is morphia 
with atropia hypodermically in energetic doses. The amount required 
to allay pain is often astonishing. 

A turpentine stupe over the abdomen or hot fomentations are often 
helpful. Carbonate of ammonia or other stimulants may be required. 
A mild injection may be administered to unload the bowels if nec- 
essary, but active cathartics ought not to be given. In recent 
practice Epsom salts in small and frequent doses is sometimes 
administered to liquefy the contents of the bowels and such practice 
has proved successful. 

XIII.— COLIC. 

This is a pain of the bowels without inflammation, and is caused 
by over-distension of the intestines with gas, indigestible substances 
as unripe fruits, and neuralgia of the bowels. It is sometimes due to 
malaria, to hot weather, impure water, or it may result from lead- 
poisoning. The pain ' occurs in paroxysms of a twisting, griping 
character. 

SYMPTOMS. 

These are pain in the center of the abdomen, more liable to occur 
at night. It differs somewhat from the pain in neuralgia of the 
stomach. It is abdominal. The pain may be very severe but there 
is little or no soreness or tenderness upon pressure. The attack may be 
brief or last several hours. A free evacuation of the bowels or dis- 
charge of gas may bring sudden relief. Infants often suffer much 
from this affection, as when they cry, draw up their limbs and show 
signs of intense distress. The pain from colic resembles that of gall 
stones, ulcer of the stomach, strangulation of the bowels and renal 
colic, but is easily distinguished from these by the observing nurse or 
practitioner. 

TREATMENT. 

Lead colic demands an evacuation of the bowels, as obstinate con- 
stipation has existed in these cases. The sulphate of magnesia is a 



THE NEW MEDICAL WORLD. 389 

safe pl^sic to use in these cases. It is cooling in its nature and does 
not excite inflammation. When caused by distension of the bowels 
with indigestible substances, an emetic may be of service. Warm 
rectal injections help to unload the colon and rectum and can do no 
harm if carefully administered. Hot applications may be applied 
over the abdomen and hot herb tea administered, as catnip, spearmint, 
composition or Jamaica ginger. After unloading the bowels, a dose 
of paregoric may be administered. 

Infants may be relieved of wind colic by a few drops of the essence 
of anise or an infusion of anise seed. When the pain is persistent 
and does not yield to warm external applications and hot internal 
remedies, the possibility of confounding colic with some more serious 
affection should be considered and timely assistance sought. 

XIV.— CONSTIPATION. 

Constipation is that condition in which the contents of the bowels 
are retained longer than is beneficial or proper, and when expelled 
the act is accomplished with difficulty, the faecal matter having 
become dry, hard and scanty. It is conducive to health to have one 
full natural movement daily, and yet considerable departure from 
this rule often occurs without inconvenience or injury to health. 

Nursing children, especially those artificially fed, are often 
troubled with constipation. Old people are liable to suffer from 
this common trouble, for their habits are less active, the bowels 
become torpid and there is much inaction of the whole system.. 
The same is true of all persons whose habits are deficient in 
activities. Women are more liable to suffer from it than men 
owing to their habits of indoor life, insufficient exercise and other 
natural causes. Habit and occupation have their influence in causing 
this condition. Those who lead active and outdoor lives rarely suf- 
fer from it, while the sedentary rarely escape. 

Constipation complicates certain diseases, especially those of the 
brain, also measles, small-pox and fevers, except typhoid. Persons 
suffering from dyspepsia, as a class, are troubled with constipation. 

The taking of pills and harsh cathartics are prominent causes. 
Tea drinking, opium taking and lead absorbed into the system cause 
obstinate constipation. Certain articles of food are liable to cause 
this condition, as milk, cheese, crackers, wheat bread and many 
others. 



390 THE NEW MEDICAL WORLD. 

SYMPTOMS. 

These are generally well-known. Some of the more important 
are a sallow countenance, irritable disposition, headache, coated 
tongue, disagreeable or bitter taste in the mouth, distended abdomen, 
unrefreshing sleep, bad dreams and nervous disturbances as perhaps 
hysteria. 

TREATMENT. 

The treatment depends largely upon the age and occupation of the 
patient. Nursing infants may be relieved by regulating the diet and 
adapting the food to the especial condition of the little ones. These 
patients are benefited, when there is marked inaction of the rectal 
portion of the intestine, by warm water injections containing a little 
glycerine, or instead, a glycerine supjjpsitory may be used each 
morning until a regular habit is established. 

Persons engaged in sedentary pursuits should give attention to 
exercise, as walking, riding, bathing and daily gymnastic practices. 
Such persons ought to form the habit of giving attention each day 
punctually to this important matter. 

In most cases fruits are valuable, as an orange each morning before 
breakfast, grapes, peaches, figs, raisins, stewed prunes, apples, 
bananas and others in their season, including canned fruits at 
those seasons of the year when others cannot be obtained. 

Fresh vegetables are of great service, as spinach, dandelions, let- 
luce, asparagus, peas, tomatoes, etc. 

Fresh meats are preferable to those which have been salted or 
cured. 

Graham bread, bread made from the entire wheat, rye bread, 
brown bread, cracked wheat, oatmeal, hominy well cooked, and 
corn bread, are all healthful and beneficial in relieving constipation. 

Some persons are benefited by drinking a cup of cold water each 
morning on arising, or a cup of water to which a small teaspoonful 
of common salt has been added. 

If, in addition to these simple and natural remedies, a laxative is 
occasionally required ; the granular effervescent citrate of magnesia is 
recommended. In cases where more energetic remedies are de- 
manded podophyllin, combined with nux vomica, will prove almost a 
certain cure for obstinate cases of chronic constipation. 

These remedies may be rendered still more efficient by combi- 



THE NEW MEDICAL WORLD. 391 

nation with cascara-sagrada and belladonna. The following formula 
may be used and will prove a positive cure for the most chronic 
cases : 

^ Podophyllin one grain 

Ext. nux vomica three grains 

Ext. belladonna four grains 

Ext. cascara-sagrada twenty grains 

Oil peppermint two grains 

Mix and make twenty pills. 

Dose one, two or three times a day, gradually leaving off the 
medicine as the natural habit becomes regularly established. This 
treatment may be continued, if necessary, for several weeks, or long 
enough to effect a cure. 

Those cases complicated with dyspepsia are benefited by taking a 
two or three grain pepsin powder with each meal. Debilitated cases 
will need in addition to the foregoing remedies tonic doses of salicin 
or calisaya bark. 

{ XV.— WORMS. 

We understand by worms a variety of parasites which are found 
occasionally in the intestinal canal of the human body. These unwel- 
come guests occasion more or less inconvenience which is manifested 
in many ways. 

Formerly they were regarded as of much more importance than at 
present. In fact, there are but few diseases and symptoms which 
have not been attributed to worms. 

SYMPTOMS. 

These are of two kinds, known as local and systemic. The 
former may be enumerated as uneven and fitful appetite, disordered 
digestion and abdominal pains; the latter are cough, chorea, convul- 
sions and other nervous disturbances which mav be either so slight 
as to escape notice or so grave as to occasion alarm. The most 
certain symptom, however, is the discovery of worms in the stools. 

When these parasites exist in large numbers, they are unde- 
sirable mischief makers and their speedy expulsion is necessary. 

The three most common varieties are the tape worm, the thread or 
seat worm and the round or stomach worm. There are several 



392 THE NEW MEDICAL WORLD. 

kinds of tape worm, but in this connection it is unnecessary to 
multiply descriptive details. 

Tape Worm. — The mature tape worm is a long, flat white worm, 
deriving its name from a fancied resemblance to a piece of tape. 
The head is small, the neck slender and it gradually widens out 
toward the body. The tape worm fastens itself to the mucous lining 
of the intestines with a firm hold hanging on by means of hooklets. 
It maintains its position with such tenacity that its removal is diffi- 
cult. 

It is of interest to observe that the tape worm has no mouth, 
stomach or alimentary canal, but maintains its own life by absorbing 
the fluids with which it is surrounded. 

As the lower segments mature and the eggs become thoroughly 
developed, they separate and are discharged with the stools. One of 
these segments or rings contains from thirty to forty thousand eggs, 
and since only one individual worm as a rule inhabits the human in- 
testine, the query is of unusual interest, how does this parasite gain 
access to the human body in the first place ? 

ORIGIN. 

A singular fact concerning this parasite is that it requires an 
abode in the bodies of two different animals in order to com- 
plete its development. Another singular fact is that this para- 
site reaches its habitat by means of the food supply. It has been ex- 
plained how the lower segments containing a numerous supply 
of developed eggs are discharged with the faecal matter. If the ripe 
eggs contained in one of these segments are in any way able to 
reach the stomach of the pig or ox they hatch out into larvae 
and migrate into the muscles, where they exist one or two years 
enclosed in a small cyst. These encysted larvae are so small as 
to escape detection in the flesh of beef. In pork they are slightly 
larger and can be detected by the naked eye. 

We now see how easy it is, since these eggs retain vitality for an 
indefinite period, for them to be taken in with the food of animals > 
while feeding in the pastures and ranches far away from human 
habitations but under constant human oversight. 

When the flesh of beef or pork containing one of these embryos 
or encysted larvae is eaten without being sufficiently cooked, it is 



THE NEW MEDICAL WORLD. 393 

introduced into the human alimentary canal where the second or real 
development of the tape worm takes place. 

The common source of tape worm is from beef, for although the 
larvae are more numerous in pork, owing to the unclean habits of the 
pig, pork is seldom eaten rare or slightly cooked like beef, and 
thorough cooking destroys their vitality. 

A full grown tape worm reaches its full second development after 
entering its human abode in the short space of three months, and in 
this brief time may reach a length of thirty feet. 

A certain diagnosis of tape worm is easily made because the rings 
or terminal segments are discharged with the stools. 

TREATMENT. 

Preventive treatment consists in avoiding raw or very rare meat. 
Pork especially should always be adequately cooked before it is eaten. 
In order to commence medical treatment for the removal of a tape 
worm, a day or two of fasting and a mild cathartic to clear out 
the mucous and unload the bowels is essential. The preparatory 
cathartic should be taken at night and the expelling medicine given 
the next morning. It takes from three to four hours to remove the 
parasite after the expelling medicine has been taken. The prescription 
which will accomplish this result without danger and with absolute 
certainty is given and caution is emphasized to prevent an improper 
use of it. 

5, Ext. of male fern ethereal three drams 

Chloroform pure one dram 

Emulsion of castor oil two ounces 

Croton oil two drops 

Syr. of spearmint one ounce 

Mix. The preliminary directions having been followed, shake the 
bottle thoroughly and take one half of the above prescription on 
an empty stomach, and half an hour afterwards take the remainder. 
The patient should lie quietly on a lounge while under the influence 
of the medicine, as it makes one slightly drowsy, but no ill effects 
follow its use, and when the medicine acts the entire tape worm will 
be found in the stool. 

Thread Worms. — These minute, but active parasites prevail the 
world over. They are sometimes called pin or seat worms. They 



394 THE NEW MEDICAL WORLD. 

are especially troublesome to children. They are remarkably pro- 
lific, a single female producing successively ten or twelve thousand 
eggs, which are deposited in the folds of the rectum, where they 
speedily develop. These worms inhabit both the small and large 
intestines. 

SYMPTOMS. 

Of the few unpleasant symptoms the most prominent is itching 
about the rectal orifice, which is always annoying. They cause 
children much restlessness at night, and sometimes convulsions or 
chorea. 

TREATMENT. 

A dose of Epsom salts and senna will remove them in large num- 
bers. A dose of castor oil containing from three to five or ten drops 
of turpentine will also expel them. The following is an efficient and 
excellent prescription : 

r} Santonine twenty-four grains 

Podophyllin six grains 

The mild chloride of mercury twelve grains 

Pulv. sugar forty-eight grains 

Titurate these together thoroughly and divide into twenty-four 
powders, give one each night and morning for two or three days. 

After the worms are expelled inject a mild decoction of aloes. 
Open and wash all the folds about the rectum with this bitter fluid, 
then apply a carbolized salve. This treatment persisted in faithfully 
a few times will destroy them utterly. 

Round Worms. — These are also called stomach or lumbricoid 
worms. They are a common and well known parasite. They are 
supposed to reach the alimentary canal from unfiltered drinking 
water. Poverty and filth are conditions which favor their develop- 
ment, although they are found in all ranks of society. They are re- 
markably prolific, one female being adequate for the production of 
several million eggs, and these eggs retain their vitality for years. 

SYMPTOMS. 

These are foul breath, disordered appetite, flatulence, furred tongue, 
abdominal pains, dyspepsia, emaciation, grating of the teeth at night, 



THE NEW MEDICAL WORLD. 895 

picking the nose, pallor about the mouth and nose, bad dreams, 
muscular convulsions and fits. Xo one person is likely to present all 
these systoms, perhaps only one but more frequently several of them. 

TREATMENT. 

The fluid extract of pink root and senna is an old time remedy 
The dose is from one-half to two teaspoonfuls according to age. 
This is an efticient remedy but from its liability to produce temporary 
nervous symptoms it is not used as much as formerly. 

The best because most satisfactory remedy and the one sanctioned 
everywhere by modern usage is santonin e. It is given with sugar. 
The dose is two or three grains. Its efficiency is increased by com- 
bining with it the same amount of calomel. Should the latter remedy 
be considered objectionable, podophyllin in doses of from one-sixth 
to one-quarter of a grain can be combined with it with equal efficiency, 
although it is not as pleasant to take. The following prescription is 
admirable. 

1^, Santonine \ twenty grains 

Calomel twenty grains 

Podophyllin four grains 

Pulv. sugar forty grains 

Mix and make twenty powders. Give one each night and morning 
for two or three days at a time as occasion requires. 



CHAPTER XXIII. 
THE KIDNEYS AND THEIR DISEASES 



C. — Description of the Kidneys. II. — The Secretion of the 
Kidneys. III. — Diseases of the Kidneys. 1. Gravel. 
2. Renal Colic. 3. Pyelitis. 4. Abscess. 5. Can- 
cer. 6. Hydatid Disease. IV. — Bright's Disease. V. 
— Diabetes. VI. How to Preserve the Health of the 
Kidneys. VII. — The Supra Renal Capsules. 

L— DESCRIPTION OF THE KIDNEYS. 

THE kidneys are two small, but important, glandular organs, 
situated one on each side of the spine in the lumbar region. 
The right kidney is placed a little lower than the left to accom- 
modate the liver, which occupies a large amount of space upon the 
right side. 

The outer portion of the kidneys is known as the cortical sub- 
stance. It is of a dark, red color, soft and easily torn. The inner 
portion is called the medullary substance. It is of a more dense 
structure than the outer portion and differs from it considerably 
in appearance. 

The kidneys contain many little tubes which converge into 
pyramids, and the cones of these pyramids contain many hundreds of 
openings, minute outlets which empty into what is known as the 
pelvis of the kidney. 

The pelvis is sinrply the upper and dilated portion of the ureter, a 
tube more than twelve inches long in the adult, and about the size of 
a goose quill. There are two ureters, one of which extends from 
each kidney and opens into the base of the bladder for the purpose 
of conveying the secretions of the kidneys into a common reservoir. 

We will content ourselves with this brief description of the kid- 
ne} r s, since their anatomy is not of sufficient interest to be minutely 



THE XEAV MEDICAL WORLD. 



397 



detailed. The subject is complex and difficult to describe, and 
in fact but little was known of these organs till the power of the 
microscope rendered a study of their structure intelligible. There is 
no portion of the human body whose anatomical description is more 
technical and uninteresting to the general reader 




Vertical Section of Kidney. 



The function of the kidneys, however, is very important. They 
are liberally supplied with blood from which they secrete a large 
amount of both solids and fluids, waste products which are held in 
solution until they can be eliminated from the system. If for any 
reason the work of the kidneys is impaired so that they fail to elimi- 
nate these poisonous products, serious or fatal consequences soon 
result. The health of these organs is of the utmost consequence to 
the well being of every one. The kidneys are subject to inflammations, 
degeneration and a variety of important diseases. 



398 THE NEW MEDICAL WORLD. 

II.— THE SECRETIONS OF THE KIDNEYS. 

The kidneys secrete from the blood an amber colored fluid of a 
peculiar odor. The color of the urine is derived from the coloring 
materials of the blood. 

The amount secreted depends upon several things, as the amount 
of fluid taken into the system the nature of the food consumed and 
the temperature. In hot weather much moisture passes out of the 
body through the pores of the skin, decreasing the amount of urine 
secreted by the kidneys to a very considerable extent. Vegetable 
foods and fruits of many kinds increase the amount of urine, as does 
also the free use of water and liquids. 

The specific gravity of the urine depends upon the amount of solids 
it contains and normal urine varies between 1015 and 1025. 

In health the urine is acid in reaction and turns blue litmus paper 
red. After eating and during the process of digestion it may be slightly 
alkaline for a short time or turn red litmus paper blue. The urine 
contains in solution a number of solid products, as urea, urates, 
salts of sodium, potassium, lime and magnesium, the most abundant 
of which is urea. This is a waste product which results from the 
activities of the individual, and its elimination is as much a nat- 
ural process as the taking of food. If for any reason the elimination 
of this waste product is hindered, the whole system is soon disturbed, 
and a complete stopping of the elimination of urea produces death 
in three or four days. In sickness the urine is often highly colored, 
showing that changes are rapidly taking place in the system. When 
the urine contains bile in considerable amount, it is of a dark brown 
color. The urine contains a large quantity of urates in many 
diseases which render it turbid on cooling. 

It is to be remembered that certain medicines and food j)roducts 
affect perceptibly the color of the urine, and that upon standing, all 
urine deposits a sediment. 

Such abnormal products as albumen and sugar in the urine are 
characteristic sj 7 rnptoms in certain diseases. From these facts and 
others of like import it is easy to understand that an analysis of the 
urine is frequently of the utmost importance in the diagnosis of disease. 

Those deposits which are harmless and indicate no suspicion of 
organic disease are likely to excite great alarm, while those that indi- 
cate serious or incurable disease can only be discovered by the 
careful application of tests. 



THE NEW MEDICAL WORLD* 399 

Albumen in the urine is easily discovered by means of boiling a 
small quantity of the suspected fluid in a test tube and then adding 
a drop or two of nitric acid. The acid dissolves any normal product 
as the phosphates, which the urine may contain but does not dissolve 
albumen. 

Several chemical tests may be used for the detection of sugar. 
A very convenient and delicate one is made by boiling a small quan- 
tity of Fehling's test fluid in a glass tube, after which add a small 
quantity of the suspected urine and repeat the boiling. If the added 
urine contains sugar, the test fluid changes to an orange color and 
becomes turbid, otherwise it retains its natural color which is blue. 

III.— DISEASES OF THE KIDNEYS. 

Q ravel. —There are a few diseases of the kidneys of sufficient 
importance to receive special notice. Among these may be mentioned 
gravel or calculi, which form in the pelvis of the kidney. Gravel 
exists in the form of sand or little stones formed from the crystallizable 
substances as uric acid, or oxalate of lime which is ordinarily held in 
solution in the urine. If these concretions are small, they are called 
gravel, but if large they are known as calculi. When a gravel forms 
in the pelvis of the kidney, one of two things may happen, it may 
pass down the ureter into the bladder, or. it may remain in the pelvis 
of the kidney constantly increasing in size in which place sooner or 
later, it will excite inflammatory action. 

Renal Colic. — When a gravel or a calculus passes from the pelvis 
of the kidney to the bladder, it occasions sudden and terrific pain of 
a cutting type. This pain is attended by a frequent and urgent desire 
to pass water which is voided in small quantities and usually contains 
some blood. In severe attacks there is nausea, vomiting, excruciating 
pain and coldness of the surface. 

After the gravel or calculus has passed into the bladder, the patient 
experiences a glad sense of relief. An attack of renal colic may last 
a few hours or for several days. 

If the calculus passes out of the bladder with the urine, it will 
occasion no further trouble, but should it remain it will become the 
nucleus of a stone in the bladder and occasion decided trouble later. 

Treatment. — A warm bath may be employed and hot applica- 
tion over the seat of the pain, hot drinks may be taken and as 



400 THE 1N T EW MEDICAL WORLD. 

suitable dose of some anodyne as morphine, administered. It may 
be necessary to give one-fourth of a grain to afford relief and to 
repeat such a dose in a short time, for renal colic does not yield 
to ordinary measures. The ease afforded by the morphine and the 
relaxation it causes favor the passage of the calculus into the bladder. 

Pyelitis. — Inflammation of the pelvis of the kidney is known 
as pyelitis. When a calculus is too large to pass out of the pelvis of 
the kidney it is retained and is liable at any time to set up an 
inflammation, resulting in the formation of pus. The symptoms 
of this affection are difficult to detect. There may be pain in 
the loins, chills and fever, emaciation and exhaustion, accompanied 
bv a frequent desire to pass water. 

Abscess. — The formation of an abscess in the pelvis of the kidney 
is a rare and obscure affection. If it bursts and the pus passes into 
the bladder with the urine the result is favorable, but should the pus 
pass into the abdominal cavity it would most likely excite peritonitis, 
followed by death. 

Sometimes, though rarely, a whole kidney becomes obliterated, 
having been converted into a mass of pus. Treatment for such 
an affection taxes the patience and skill of the surgeon. It is pro- 
longed and must be adapted to the individual case. 

Cancer. — Cancer of the kidney is a rare affection, but sometimes 
results from cancerous disease extending from some other organ 
or part of the body. The symptoms are obscure and often unrecog- 
nized. In general they are bloody urine, pain, emaciation, exhaustion 
and the development of a tumor in the lumbar region. The cure 
of such an affection is out of the question, and the best that can be 
done is to relieve the pain and make the patient comfortable. 

Hydatid Disease. — Hydatid disease of the kidneys may occur. 
It is a parasitic affection, having the same origin as hydatid disease of 
the liver, which see. 

IV.— BRIGHT'S DISEASE. 

This name includes several organic diseases of the kidneys, in 
which albumen is found in the urine together with the epithelial 
casts which line the tubules. Richard Bright, a London physician, 
in the year 1827, was the first one to call attention to the symptoms 
and pathology of this disease, and hence its name. 



THE NEW MEDICAL WOBLPj 401 

Bright's disease may exist in either the acute or chronic form, 
and in either case it is an inflammation of the kidneys. 

CAUSES. 

The causes of this affection are acute diseases as scarlet fever. 
intemperance, mental anxiety, gout, lead-poisoning or taking coldL 
Pregnancy, in some instances, appears to favor its development. 

SYMPTOMS. 

The following symptoms may develop as the result of exposure, 
dull pain in the back, chills followed by fever, headache, pain in the 
limbs, nausea and vomiting, and a frequent desire to pass water. 

Other less acute symptoms are the presence of albumen in the 
urine and the existence of dropsy. The face about the eyes is puffy 
and the limbs are swollen. 

The dropsy may subside and the patient recover. This is quite 
likely to be the case when the disease follows scarlet fever. In other 
cases the severity of the symptoms may increase, dropsy becoming 
o;eneral and the termination of the case may be attended bv a train 
of hopeless symptoms as convulsions, coma and death. 

This disease may pass into a chronic state and continue for one, 
two or three years or any indefinite period. Recovery is said to have 
taken place even in the chronic stages, but more frequently the 
symptoms become severer until death ensues. 

The detection of albumen in the urine constantly and the jjresence 
of tube casts are the two features which unite and confirm the 
diagnosis. The amount of albumen contained in the urine is in 
proportion to the extent and severity of the inflammation. The 
existence of albumen is easily detected. (See the secretions of the 
kidneys.) The existence of tube casts requires some experience and 
a good microscope. Tube casts are the lining of the uriniferous 
tubules and are composed of epithelial cells, and when they are 
found in the urine, they indicate that important and destructive 
chano-es are p'oino; on in the kidnevs. 

Dropsy is the escape of the watery portions of the blood into the 
various tissues of the body. It is often a troublesome symptom in 
Bright's disease. When the kidneys fail to eliminate the urea 
properly from the blood, uraemic symptoms develop such as a peculiar 



40:2 THE NEW MEDICAL WORLD. 

sweetish or sickish odor about the patient, headache, defects of sight 
and hearing, muscular convulsions, drowsiness and finally profound 
stupor from which the patient does not rally. 

TREATMENT. 

Since Bright's disease is a name which is applied indiscriminately 
to several forms of kidney disease, the difficulty in the way of 
domestic practice can be easily anticipated. 

In addition to the acute and chronic inflammations are the changes 
which the kidneys themselves undergo during the progress of this 
disease. There is first the large white or waxy kidney, and later the 
granular or contracted kidney, also the fatty and amyloid degenera- 
tions which occur and are known under the general name of Bright's 
<disease. 

No uniform method of treatment can be recommended for a disease 
which presents so many different stages. There is no disease 
which requires more careful study to ascertain the condition of the 
patient, and no disease in which it is more important that the reme- 
dies selected should be skillfully chosen or employed. In a gen- 
eral way it may be said of all cases that hygienic measures are 
of importance Exposure to cold and other climatic changes should 
be avoided by wearing flannel next to the skin. Alcohol should 
be regarded as an injurious stimulant to the kidneys and avoided. 
In nearly all these cases milk, skim milk or butter milk, are excel- 
lent articles of diet. When the stomach is irritable milk may be 
combined with lime water. Meats should be used with caution, 
and if necessary, entirely excluded. 

The activity of the skin should be encouraged, sweating is often 
beneficial and relieves the kidneys of considerable burden. 

When uraemic symptoms appear much relief is often afforded by 
the free evacuation of the bowels. Cream of tartar water is ex- 
cellent in these cases. It may be used freely and sometimes com- 
bined with digitalis to advantage. The prescription of digitalis 
and caffein, as found on another page, is excellent to remove dropsical 
effusions. 

Complications of this disease are numerous and require appro' 
priate treatment. 

In every case it is better to regulate the diet and trust to nature 
rather than to adopt harsh remedies or excessive medication. 






THE NEW MEDICAL WORLD. 403 

V.— DIABETES. 

Diabetes is the name given to a set of symptoms associated with 
the derangement of various functions especially of the liver and kid- 
neys and on account of which a large amount of sugar is passed 
into the blood and secreted by the kidneys. 

Three things may be said to characterize this disease ; they are a 
large increase in the amount of urine, the constant presence of sugar 
in it and a decided wasting of the bodily tissues. 

CAUSES. ' 

While the causes of this disease have not been satisfactorily deter- 
mined, a hereditary tendency has been observed and has recently 
been coming more and more into prominence. Much attention has 
been given by way of study and research to the causes of diabetes, 
but they are still somewhat obscure. 

These facts are established, namely, that males are more subject to 
it than females ; that it is more prevalent between the ages of thirty 
and forty. Lean and fleshy persons alike are its subjects. Fleshy 
persons who indulge freely in the luxuries of the table, who live a 
sedentary life and are troubled with indigestion, are believed to be 
more liable to this disease than others who are abstemious, live an 
active life and have a good digestion. Lean persons who are the 
victims of business troubles, who are given to anxiety and mental 
worry suflicient to disturb the cerebral functions, are classed among 
those liable to the development of diabetes. 

Among exciting causes may be mentioned nervous shock, mental 
distress or anxiety and profound emotion. Excesses of various kinds 
have been regarded as the starting point of this disease, as intemper- 
ance, high living and sexual indulgence. Some cases have been 
accounted for by injuries of the brain and nerve centers. It is also 
thought that some cases are caused by fevers, malaria, gout, rheu- 
matism and exposure to cold. 

SYMPTOMS. 

It is probable that this disease may exist for some time without 
being recognized. The first thing noticed is usually the passing 
of a large amount of urine at frequent intervals, thirst and a peculiar 
dryness of the mouth and skin. Other symptoms which develop 



404 THE NEW MEDICAL WORLD. 

later are loss of weight, muscular weakness and diminution of sexual 
desire. There may be indigestion, vertigo, headache, double vision, 
wakefulness, neuralgia or an exhausting cough. Later symptoms are 
a flagging and irregular heart, peculiar fruity odor of the breath, and 
in extreme conditions coma. The thirst is excessive, there may 
be functional derangements of hearing or vision, and also impaired 
taste. 

Boils and affections of the skin may occur. The amount of sugar 
contained in the urine varies greatly. Diabetic patients are some- 
times the victims of consumption or jaundice- 

TREATMENT. 

The most important part of the treatment for diabetic patients has 
reference to the diet. From it must be eliminated all those articles 
which contain sugar and starch. The functions of the liver are so 
deranged that what are known as the carbo-hydrates cannot be 
handled, hence they increase the trouble and work mischief. 

The most successful method of eliminating these objectionable 
articles of food is by an exclusive diet of milk. Skim milk is 
preferable. Its use often causes the disappearance of sugar from the 
urine and great amelioration of the condition. A tumbler full or 
more every two hours is necessary to maintain the bodily waste. 
Peptonized milk is excellent and the directions for preparing it 
are given elsewhere. 

Other articles of food are admissible when the patient for any rea- 
son cannot subsist on milk exclusively, as beef, mutton, tripe, tongue, 
poultry, game, fish, lobsters, clams, oysters and soups, without 
rice or flour. The following vegetables are admissible : Cabbage, 
cauliflower, string beans, asparagus, spinach, dandelion, lettuce, 
radishes, onions, cucumbers and others of similar character. Among 
the fruits suitable to use are cranberries, plums, cherries, strawberries 
and apples, but without the addition of sugar. Saccharin may be 
used with entire satisfaction to take the place of sugar. 

Bread made of gluten flour may be used, and from the above list a 
very agreeable and palatable bill of fare can be arranged. 

Favorable hygienic surroundings and correct habits of living 
are essential. The functions of the skin and liver should be kept 
active. Mineral waters have been highly praised for this affection. 
Especially worthy of notice are Vichy and Carlsbad. The prepared 
effervescent salts mav be used instead. 



THE NEW MEDICAL WORLD. 405 

Codeia has obtained considerable repute for diminishing the 
amount of sugar, beginning with a fourth of a grain three times a day 
and gradually increasing the dose until characteristic effects are 
produced. Other remedies made use of in the treatment of this dis- 
ease are ergot, iron, arsenic, strychnia, bromide of potash, the phos- 
phates and the chloride of gold and soda. Claims have been made 
from time to time for many other remedies, but most of them have 
proved disappointing. 

The best possible results are obtained by a carefully restricted diet, 
healthful surroundings and such medicines as are indicated by 
the svmptoms and the idiosyncrasies of the patient. This disease is 
too formidable for domestic treatment, except from the hygienic and 
dietary standpoint. 

VI.— THE SUPRA-RENAL CAPSULES. 

Above and in front of the upper portion of each kidney is a small 
irregular shaped glandi known as the supra-renal capsule. These 
glands are not very liable to disease. Their function is unknown and 
their consideration is of minor importance. 

The disease with which they appear to be most frequently associated 
is known as Addison's. This is characterized by excessive pros- 
tration, weakness of the heart and a peculiar bronze discoloration 
of the skin. The cause of this disease is unknown, but when it 
exists, it is found that the supra-renal capsules are in a condition of 
degeneration. It is not a common affection. No cure follows the 
administration of medicines and their use can only relieve the urgency 
of the s3^mptoms. 

Rest, pure air, a milk diet and tonics to prevent poverty of the 
blood are all of service in its treatment. The danger of exhaustion 
should be borne in mind and excessive mental or bodily exertion 
should be avoided. 

VII.— HOW TO PRESERVE THE HEALTH OF THE 

KIDNEYS. 

The health of the kidneys is best maintained by giving suitable 
attention to the diet. An excessive use of meat or nitrogenous food 
adds to their labor and may hasten a breaking down of their tissues 
when a tendency to disease exists. 



406 THE NEW MEDICAL WORLD. 

Sudden changes of temperature often affect the kidneys unfavora- 
bly by checking the activity of the skin and increasing the eliminative 
work of these organs. Ice water, when over-heated, or other means 
of rapidly cooling off, getting drenched with rain and similar expos- 
ures may be the means of arousing to activity the slumbering 
tendencies to Bright's disease. 

Exercise and life out of doors in an even climate and the practice 
of good habits, the use of pure water, the avoidance of alcoholic 
drinks are preventive measures worthy of earnest consideration by 
those who have reason to suspect any weakness or inherent tendency 
to disease in these important organs. 



CHAPTER XXIV. 

THE BLADDER AND THE URINARY 
APPENDAGES. 



I. — Description of the Bladder and Neighboring Tissues. 
1. The Ureters. 2. The Urethra. 3. The Prostate 
Gland. 4. Cowper's Gland. II. — Acute axd Chroxic 
Cystitis, or Catarrhal Inflammation of the Bladder. 
III. — Retention of Urine. IV. — Suppression of Urine. 
V. — Enuresis, or Incontinence of Urine. VI. — Stone 
in the Bladder, or Vesical Calculus. VII. — Enlarged 
Prostate. Ylli. — Other Obscure Affections. 

1 .—DESCRIPTION OF THE BLADDER. 

THE bladder is a membranous cone shaped sac or reservoir for 
the purpose of holding the urine until it is convenient to void it. 
It is situated in the front part of the pelvic basin, and when distended, 
ascends well up into the abdominal cavity. It is held in position by 
several ligamentous bands. Its average capacity is about one pint. 
It is made up of three layers or membranes, a serous, muscular and 
mucous. The muscular coat has two layers of tissue, the outer com- 
posed of longitudinal and the inner of circular unstriped muscular 
fibers. The mucous layer is a smooth surface covered by epithelium 
and forms the interior lining of the bladder. It is of especial interest 
on account of the several important diseases to which it is liable. It 
is supplied with vessels and nerves which are branches of those 
which supply the other parts of the pelvis. 

The Ureters. — The ureters are canals leading from the kidneys 
and terminating in the lower portion of the bladder by means of 
small openings. Through these canals, about eighteen inches long, 
and the size of a goose quill, the urine passes from the kidneys 
where it is secreted, to the bladder. 



408 THE NEW MEDICAL WORLD. 

The openings of the ureters are situated one on each side of 
the base of the bladder, about two inches apart and about an inch 
and a half from its neck. 

The Urethra. — The canal which conveys the urine out of the 
bladder is larger than the caliber of the two ureters combined. It is 
sometimes the seat of annoying disease. 

On the under side of the bladder in the male are small, irregularly 
shaped reservoirs, the vesicular seminales. These contain the seminal 
fluid and open by a duct into the urethra. 

The Prostate Gland. — Just in front of the neck of the bladder, 
the male urethra is surrounded by a glandular body an inch or more 
in length, weighing nearly an ounce, and known as the prostate 
gland. It is about the shape and size of a horse chestnut. It 
secretes a milky fluid, which mingles with and dilutes the seminal 
fluid. When the condition of this gland is abnormal it occasions 
considerable annoyance. 

A small amount of prostatic fluid appearing at the close of urina- 
tion is often erroneously regarded as a symptom of some disease of 
the sexual organs. This is, however, of slight significance, having no 
connection with the seminal fluid, and should occasion no concern. 

Cowper's Glands. — A short distance in front of the prostate 
gland are two other small glands about the size of a pea which 
open by means of ducts an inch and a half long into the urethra 
and known as Cowper's Glands. They secrete a thin fluid resem- 
bling mucous. The function of these glands has not been 
positively determined, and since they are not often subject to impor- 
tant diseases, their further consideration is considered unnecessary. 



IT— ACUTE AND CHRONIC CYSTITIS OR CATARRHAL 
INFLAMMATION OF THE BLADDER, 

Cystitis is the most frequent of all the diseases of the bladder. It 
may be acute or chronic, An acute attack usually precedes the 
chronic form of the disease. Mild forms of the disease may exist 
which are little more than an irritation and yield readily to treatment. 
In all cases the secretion of mucous is more or less augmented. 



THE NEW MEDICAL WORLD. 409 

CAUSES. 

It may result from a variety of causes, as stone in the bladder, an 
extension of gonorrhoea] inflammation or stricture of the urethra. 
It may appear in dyspeptic subjects as the result of indigestion which 
causes the urine to be excessively acid. It may be caused by the 
excessive use of irritating drugs as the result of taking all sorts of 
patent medicines. The decomposition of retained urine is a frequent 
cause of cystitis in old people who are unable to completely empty 
the bladder. One or several of the foregoing causes may exist at 
the same time. 

SYMPTOMS. 

The symptoms are characteristic. There may be chills followed 
by fever, a frequent desire to void the urine and smarting or burning 
of the urinary organs. The act of urinating may be painful, attended 
by straining and afford no relief. 

The symptoms become more intense in proportion to the extension 
of the inflammation. The urine presents an altered condition, con- 
taining a large amount of mucous and sometimes pus and blood. If 
the bladder is not thoroughly emptied, the retained urine becomes 
foetid and ammoniacal, augmenting the difficulty. 

TREATMENT. 

In order to treat this disease successfully it is necessary, if possible, 
to ascertain its cause. When cystitis is caused by calculus or other 
foreign body in the bladder its removal should be accomplished. 
When caused by the drug- taking habit this foolish practice must be 
abandoned. If due to the retention of urine a catheter may be 
passed and the bladder completely emptied. This may afford relief. 
In an acute attack rest in bed is favorable to recovery. Alkaline 
drinks, as the effervescing bicarbonate of potash in teaspoonful doses, 
dissolved in water, afford a measure of relief. Flaxseed tea and 
milk may be freely used and are both soothing and nutritious. The 
following may be used with good results : 

I?, Acetate of potash one ounce 

Fl. ext. buchu half an ounce 

Sweet spirits of nitre one ounce 

Wintergreen water q. s. to make four ounces, 



410 THE NEW MEDICAL WORLD. 

Mix. Dose a dessert spoonful or more every four hours in a wine 
glass of water. 

When there is much pain the following will be found efficient : 

3 Pulv. opium six grains 

Cocaine four grains 

Ext. hyoscyamus six grains 

Cacao butter q. s. to make twelve suppositories 

Insert one into the rectum and repeat every four hours until 
the pain is controlled. 

When acute cystitis has passed into the chronic form, it is often 
obstinate and hard to cure. Good results are obtained in such cases 
from washing out the bladder daily with a fountain syringe and the 
following : 

^ Pulv. borax two drams 

Cocaine four grains 

Hot water one or two pints 

A quart of water containing a little table salt is also excellent. 

Stronger solutions containing more efficient remedies may be used 
by the physician. 

Salol in doses of from two to five grains may be taken internally 
to prevent the decomposition of the urine. When much pain exists, 
phenacetine may be combined with it. Tablets containing two and 
a half grains of each remedy may be obtained and one taken an 
hour after each meal. The prescription of suppositories for acute 
cystitis will relieve the pain of the same affection somewhat when it 
has reached the chronic stage. Alkaline mineral waters are beneficial 
in the chronic form of cystitis. 

III.— RETENTION OF URINE. 

Retention of the urine is not a common affection, except it is 
caused by a calculus in the bladder, gonorrhoea, a stricture of the 
urethra, paralysis of the bladder, some injury, or the use of irritating 
drugs. It occurs sometimes in the case of very old people. Spas- 
modic retention may occur in acute diseases when nervous control is 
diminished or lost. In spasmodic retention hot applications, a hot 
hip bath, or hot water bags may afford relief. If such simple means 
do not avail the prompt use of a suitable catheter is demanded. 



THE NEW MEDICAL WORLD. 411 

For the majority of cases the soft elastic is preferable to a hard or 
metallic catheter. When retention of urine is due to enlarged 
prostate that affection should receive attention. (See enlarged 
prostate. ) 

When it is due to a calculus or tumor it needs to be removed ; 
when due to stricture or gonorrhoea these affections require ap- 
propriate treatment. When retention is due to paralysis of the blad- 
der strychnia is the best known remedy. It may be given in doses of 
one-sixtieth of a grain two or three times daily after meals, and con- 
tinued for a long time. Paralysis of the bladder often results from 
injuries or tedious labors, and requires the use of the catheter until 
this important viscus recovers its tone. Serious injury or disease of 
the spinal cord may cause paralysis of the bladder. A condition 
of paralysis resulting from labor usually recovers in a brief time 
without medicine. 

The various remedies suggested for cystitis are appropriate to use 
in retention of the urine. In addition to alkaline drinks, mineral 
waters, washing out the bladder and diuretic mixtures, it may be nec- 
essary to dilate a stricture, pass a steel sound or resort to such other 
means as the individual requirements suggest. 

IV.— SUPPRESSION OF THE URINE. 

Suppression of the urine is a much more serious trouble than its 
retention. It may be due to inflammatory action or disability of the 
kidneys so that little or no urine is secreted 

The poisonous products of the system which are constantly elimi- 
nated in health in this condition are retained, and unless relief is 
prompt, cause stupor, coma and death. 

Suppression of urine may occur in Bright' s disease or after scarlet 
fever and is a signal of imminent danger. 

It is customary in these cases to administer remedies which act 
promptly upon the skin as jaborandi, and upon the bowels as the 
sulphate of magnesia and at the same time effort is made to induce the 
kidneys to act. Hot fomentations may be used externally. Cream 
of tartar lemonade, marshmallow tea, infusion of wintergreen and 
sweet spirits of nitre are among the best domestic remedies. 

In the uraemic condition, after scarlet fever, one-twentieth of a 
grain of pilocarpin may be given to a child two years old once in 
four hours. This remedy causes profuse sweating. It may be 
obtained in the form of pills or tablets. 



412 THE NEW MEDICAL WOELD. 

Suppression of the urine indicates an urgent condition, and when 
it exists for even a brief time, a competent medical attendant should 
be consulted, who can call to his aid a much wider range of efficient 
remedies than can be advised in this work. 



y .—ENURESIS OR INCONTINENCE OF URINE. 

This annoying affection may be due to a variety of causes, as con- 
genital weakness, injury and paralysis of the nerves which control 
the bladder, or it may result from the infirmities of old age or from 
the pregnant condition. Thread worms, indigestion and an acid 
condition of the urine may cause irritation and incontinence. With 
children it may be the result of neglect and the formation of a bad 
habit. It is chiefly an affection of children who manifest some 
weakness of the pelvic organs or who have suffered from the want 
of proper care. When the habit of wetting the bed becomes fixed 
with such children, it is not only troublesome but difficult to over- 
come. 

TREATMENT, 

The cause, if possible, should be determined and remedied. Waking 
a child regularly after two or three hours of sleep helps to overcome 
the wrong and establish the right habit. Hearty suppers, especially 
of meat, should not be allowed and only a limited amount of fluid 
to drink as night approaches. It is useless to attempt to remedy this 
annoying habit by whipping. Judicious talk and moral impressions 
are preferable. 

The operation of circumcision is recommended as it affords relief 
when the prepuce is long and has been the cause of the irritation. 

For the weakness of small children there is no better remedy than 
atropia in doses of T qVo" °^ a g ram two or three times a day. The 
last dose to be given at bedtime. Its preparation is easy. Dissolve 
a tablet containing T ^ of a grain in ten teaspoonfuls of water. One 
teaspoonful of this solution is the requisite dose. 

For children over or under two years of age the dose may be in- 
creased or diminished proportionately. Other remedies which have 
proved useful are chloral, iron, phenacetine and ergot. The following 
prescription is excellent and can be used without danger, while such 



THE NEW MEDICAL WOBLD. 413 

remedies as atropia and chloral must be used, it at all, with especial 
care. In preparing this the iron and acid should be combined first. 

1$, Ext. of ergot fl. three drams 

Muriate tine, of iron two drams 

Dil. phos. acid three drams 

Syr. of orange peel one ounce 

\Vater one and one-half ounce 

Mix. Dose a teaspoonful three times a day. 

When worms cause the difficulty they can be removed by the 
treatment advised. (See worms.) 

Enuresis of the aged, due to paralysis, may be benefited by the ad- 
ministration of strychnia in doses of t ±-q of a grain three times a day. 
This remedy can be obtained in tablet form. 

VI.— STOXE IX THE BLADDER, OR VESICAL 

CALCULUS. 

The origin of stone in the bladder is usually the descent into it of 
gravel or a small calculus from the pelvis of the kidney. It may be 
retained in the bladder and become the nucleus of a larger formation. 
Its increase is from the solid constituents of the urine which are 
attracted to it and deposited upon it, causing its constant growth. A 
stone is composed of the same material as gravel, the most common 
variety is made up of uric acid, and next in point of frequency is a 
stone composed of the oxalate of lime, and next to the latter is 
a stone composed of the phosphate of lime. There are several other 
rare varieties. In some sections stone in the bladder is a common 
difficulty. 

The early symptoms may be slight and are often overlooked for 
several years. In general, the symptoms are similar to cystitis, 
a frequent desire to urinate, the act being attended by pain and 
a tendency to strain (tenesmus). During urination a sudden arrest of 
the stream is often observed, caused by the stone falling forward and 
obstructing the outlet of the bladder. The last drop of urine may be 
tinged with blood. In some cases there is more or less retention and 
incontinence of the urine. The pain may be slight or agonizing. 

The chief danger of a vesical calculus is from its liability to pro- 
duce organic changes in the kidneys and thus endanger life, The 
m<»st characteristic symptom of this affection is the click which is- 



414 THE NEW MEDICAL WORLD. 

heard by the ear and the impression conveyed to the hand of the 
surgeon after passing a steel sound into the bladder. Striking the 
stone with the sound renders the diagnosis certain. 



TREATMENT. 

The treatment is surgical and demands the removal of the calculus. 
Several methods. are now employed as cutting into the bladder or 
crushing the stone with a powerful instrument which grasps it. This 
crushing instrument is called a lithotrite and the operation is called 
lithotrity. 

Whether the cutting or crushing operation is selected depends upon 
the size and composition of the stone as well as the age and condition 
of the subject. The crushing operation is safe, if the kidneys are in 
a healthy condition, otherwise it is dangerous and liable to result 
fatally after a few days. 

After the removal of a vesical calculus, the regulation of the diet 
and other habits are essential to prevent a recurrence of the trouble. 
Preventive measures may be employed with good hope of avoiding 
a similar trouble in the future. There are no drugs or remedies 
which will dissolve a calculus after it has once formed. The use of 
such mineral w r aters as Vichy and Bedford Springs are beneficial. 
Constipation should be avoided and the various eliminative organs 
encouraged to perform their functions in a normal manner. 



VII.— ENLARGED PROSTATE. 

A consideration of the prostate gland is important from the fact 
that it is liable to enlarge and occasion trouble after fifty or sixty 
years of age. When this occurs to any considerable extent, it inter- 
feres wdth the discharge of the urine, so that the bladder is never 
completely emptied ; the retained portion called the residual urine may 
awaken inflammation accompanied by frequent and urgent- desire to 
pass water. 

It is believed that an enlarged prostate may not only awaken 
cystitis, but also an inflammatory condition w r hich will extend to the 
kidneys and may result in the development of Bright's disease, hence 
the necessity of promptly recognizing and alleviating this affection. 



THE NEW MEDICAL WORLD. 415 

SYMPTOMS. 

These may be bo obscure as to tail of recognition but ordinarily 
there is a frequent desire to urinate, the patient being obliged to arise 
several times each night for thrs purpose. The stream of urine i> 
small and considerable effort is required for its expulsion. The irri- 
tation increases, being more urgent at night than by day. There 
may be uneasiness and throbbing pain with an involuntary 
escape of urine. An increasing portion of the urine may remain on- 
passed in the bladder where it decomposes and becomes ammoniacal, 
inereasingr the irritation until a chronic condition of cystitis is estab- 
lished. Enlarged prostate is recognized by means of a rectal 
examination, it being hard to the touch and greatly increased in >ize. 

TEEATMEXT. 

The treatment calls for a thorough evacuation of the bladder 
bv means of the catheter, and washing it out daily with warm water, 
warm salt water or a solution of boric acid and water. The object 
of washing out the bladder is to get rid of the residual urine, the 
mucous and pus. and to leave the bladder in a cleansed condition, 
which tends to prevent an extension of the inflammatory action. 

When much force is used in the evacuation of the bladder its 
walls become thickened or contracted, and piles or hemorrhoids 
may result from this daily and long continued effort to void the 
urine. 

Mineral waters are beneficial and contribute to the patient's com- 
fort. The citrate of potash makes a pleasant diuretic drink. The 
granular effervescent salt is very convenient and agreeable to take. 

The bicarbonate of potash is prepared in the same manner and 
is also an efficient diuretic and antacid. 

The following affords comfort : 

r> Pulv. opium four grains 

Ext. belladonna three grains 

Ext. hyoscyamus six grains 

Iodoform one grain 

Cacao butter q. s. to make twelve suppositories 

Use one placed well up in the rectum each night or each night and 
morninor. 



416 THE NEW MEDICAL WORLD. 

For internal treatment the syrup of hydriodic acid in teaspoon- 
ful doses three times a day is an excellent remedy. It should be 
diluted with water, and care taken that the syrup is not changed 
by age. 

The fluid extract of saw-palmetto is a remedy much used in recent 
practice. One-half teaspoonful, in a little wine three times a day, is 
a suitable dose. Many cases have been benefited or cured by this 
remedy. 

VIII.— OTHER OBSCURE AFFECTIONS. 

There are a number of other rare affections of the bladder or its 
neighboring tissues, as ulceration, fistula, paralysis, tumors, tubercular 
disease, cancer, etc. These diseases are too infrequent to receive 
extended notice, too obscure to be diagnosed without professional 
skill and beyond the reach of domestic practice. 

Benign tumors can be removed from the bladder by operative 
surgery but malignant growths can only receive palliative treatment. 

Rare diseases of the bladder should be treated on general principles, 
the same as similar diseases of other organs. 

Pain in the pelvic region can usually be relieved by the introduction 
of a suppository into the rectum. For formula see acute and chronic 
cystitis. 



CHAPTER XXV. 

THE MALE GENITAL ORGANS AND 
VENEREAL DISEASES. 



I. — Description of the Male Genital Organs. II. — Affec- 
tions of the Male Genital Organs. 1. Phimosis. 2. 
Para Phimosis. 3. Congenital Malformations. 4 
Warts. 5. Cancer of the Penis. 6. The Testicles. 
7. Varicocele. 8. Hydrocele. 9. Hematocele. 10. 
Orchitis. 11. Other Minor Affections. III. — Chancre 
and Chancroid, or Venereal Diseases. IV. — Acquired 
Syphilis. V. — Hereditary Syphilis. VL — Gonorrhoea, 
Urethritis, or Clap, and its Complications. 1. Orchitis. 
2. Bubo. 3. Chordee. 4. Gleet. 5. Stricture. 6. 
Gonorrheal Rheumatism. 7. Purulent Ophthalmia. 

L— DESCRIPTION OF THE MALE GENITAL ORGANS. 

THE male genital organs require but little anatomical description 
or explanation. The structure of the penis is somewhat peculiar. 
It is richly supplied with blood vessels and nerves. The substance of 
the organ contains a plexus of veins which when congested or filled 
with blood, much increases its size rendering it turgid, but ordinarily 
the organ remains in a flaccid condition. Irritated by disease as 
gonorrhoea, the erection of this organ may be both troublesome and 
painful; a condition known as chordee, which see. The penis 
suffers from venereal diseases, it being the usual location in the male 
of chancre and chancroids. 

The penis being a part of the human body should not be regarded 
with such false modesty as to prevent it from receiving appropriate 
attention. It should not be permitted to suffer from untreated 
disease or from ignorance and neglect. Important reasons exist for 
the cleanliness of these parts which, if not observed, may lead to 
irritation, constant annoyance from itching, inflammation of the 



418 THE NEW MEDICAL WORLD. 

delicate mucous membrane and the contraction of habits which 
ought to be avoided. Young children should be taught the important 
lesson of cleanliness of these parts when taking a bath. 

There is no reason why any mother should fail to attend to her 
duty in this respect, and her neglect may lead directly to those wrong 
habits whose formation she wishes her boys to avoid. It would be 
far better to remove the redundant integument as is customary with 
the Hebrews than to have it become the cause of disease or of evil 
habits. 

II.— AFFECTIONS OF THE MALE GENITAL ORGANS. 

Phimosis. — When the foreskin cannot be brought back over the 
head of the sjland a condition exists known as phimosis. Children 
with phimosis are liable to be peevish, fretful and suffer from a train 
of reflex symptoms, such as too frequent urination, wetting the bed at 
night, irritation of the bladder and many nervous affections, includ- 
ing fits and paralysis. This condition is very common in male chil- 
dren. It prevents proper attention to cleansing and requires atten- 
tion. It may lead in the growing boy to the vice of masturbation. 

Treatment. — Stretching the orifice will sometimes avail. Cir- 
cumcision is a certain cure. It is neither a difficult nor dangerous 
operation. Where the defect is slight, slitting up the foreskin may 
prove a satisfactory measure. 

Para Phimosis. — When a narrow foreskin has been retracted 
over the gland and cannot be replaced readily the condition is known 
as para phimosis. Swelling takes place rapidly, the organ becomes 
distorted and strangulation occurs which, if unrelieved, may be fol- 
lowed by mortification. 

Treatment. — Grasp the head of the penis, compressing it with one 
hand, and with the other pull forward the foreskin and at the same 
time push back the gland. If this method does not avail the fibrous 
band which encircles it like a rubber ring can be cut through with a 
surgeon's knife. Circumcision is recommended to prevent any further 
trouble. 

Congenital flalformation. — Congenital malformation of these 
parts sometimes occurs, calling for the surgeon's art, and unless the 
deformity is great, he is successful in completing the work which 
nature has failed to perform. 



THE NEW MEDICAL WORLD. 419 

Warts. — Warts about the foreskin and gland are usually of 
venereal origin. Proper treatment consists in their removal and the 
application of the nitrate of silver to the stump. 

Cancer of the Penis. — This disease sometimes occurs after middle 
life. If left to its own course, its progress is onward and destructive. 
The treatment requires amputation of enough of the organ to com- 
pletely remove the involved tissue. By the modern surgeon this 
operation is almost painless and entirely bloodless, it being performed 
with the platinum wire heated by a galvanic cautery battery. 

The Testicles. — These are glandular organs averaging an inch and 
a half to two inches in length, an inch in thickness and weighing 
each about six drams. Their structure is somewhat complex. Thoy 
are situated in the scrotum and suspended by the spermatic cords- 
During foetal life the testicles are developed and remain in the abdo- 
men until sometime prior to birth, when they descend through an 
opening in the inguinal canal into the scrotum which is simply a sac 
or pouch adapted to their protection. Their only function is the 
secretion of seminal fluid. They are richly supplied with arterial 
blood from the spermatic arteries which accompany the cord. 

The seminal fluid is a thick, whitish substance containing sper- 
matozoa in abundance. These are germs which manifest in various 
ways remarkable vitality. Their form and movement are observed 
by means of a microscope. 

Their contact with the product of the female ovary causes concep- 
tion, a process more fully described on a later page. 

Varicocele. — Varicocele results from a varicose condition of the 
spermatic vessels. These knotted veins in the scrotum feel like 
a bunch of earth worms. This affection more often occurs upon the 
left side, owing to a peculiarity of the course and length of the 
left spermatic vein, and is sometimes supposed to be caused by 
masturbation or excesses. It is not a very important affection, and 
can usually be relieved by wearing a suspensory bandage to support 
the testicles and prevent their weight from dragging upon the cord. 

When varicocele occasions serious symptoms or severe pain the 
surgical operation of passing a ligature around the vein affords relief. 
A surgical operation is never resorted to for this affection unless 
palliative measures have failed to afford relief. 



420 THE NEW MEDICAL WORLD. 

Hydrocele. — Hydrocele is a collection of serous fluid or dropsy of 
the scrotum, which may distend it to an enormous size. This 
affection is usually more troublesome from the weight and size of the 
distended scrotum than from pain. Its discomforts are much re- 
lieved by wearing a suspensory bandage until other measures are in- 
stituted. In treating a hydrocele care must be exercised to ascertain 
that the enlargement is not due to hernia. The diagnosis is con- 
firmed by means of a lamp in a darkened room, a hydrocele being 
translucent, while a hernia is opaque. A large hydrocele is treated 
by tapping with a trocar and canula. After the fluid is drawn off 
tincture of iodine maybe injected into the sack, which will awaken 
sufficient inflammation to cause its obliteration. This method is 
known as the radical cure. 

Hsematocele. — Hematocele is a blood tumor of the scrotum. It 
may be caused by the rupture of a vessel, or from a blow or strain, or 
it may be the result of puncturing a vessel in tapping a hydrocele. 
It differs from a hydrocele in that the effusion is blood instead of 
serum, and it has a more rapid origin. This blood tumor is not 
transparent. 

Its treatment demands rest and cold lotions or ice to check hemor- 
rhage. If pus forms an opening must be made for its discharge. 
The formation of pus is a common result of a blood tumor, yet, 
if the amount of hemorrhage is small nature may be able to accom- 
plish its absorption. If the blood remains in a fluid state it may be 
withdrawn by aspiration. 

Orchitis — Orchitis, or swelled testicle, is a common complication 
of gonorrhoea. It may result from other causes, as an injury. It 
sometimes occurs during an attack of mumps, but the relation 
between an inflamed parotid gland and an inflamed testicle is not 
well understood. In this case recovery is generally satisfactory, but 
sometimes the testicles suffer permanent injury and atrophy. In- 
flammation of the testicles is generally very painful and attended by 
sickness of the stomach and disagreeable or protracted nausea. 
There may be chills followed by fever and a rise of temperature. 

Treatment. — The treatment calls for rest in bed, support of the 
testicles and hot or cold applications as may be indicated. The lead 
and opium wash is soothing. It is known as Goulard's extract. A 
poultice made of flax-seed meal and fine cut tobacco affords relief. 



THE NEW MEDICAL WORLD. 421 

When pus forms no external applications are available. It is then 
necessary to make an incision and allow the pus to be discharged. 

Orchitis may have a syphilitic origin in which case the same treat- 
ment is required as for syphilitic affections in general. 

Other Minor Affections. — There are other affections of the testi- 
cles such as tubercle, hernia, cystic and cancerous diseases, but these 
affections are so comparatively rare that the details of their synrptoms 
and treatment is not considered essential. 

Cvstic and cancerous disease requires the early removal of the 
affected testicle, an operation of but little danger and usually success- 
ful if performed sufficiently early. 

III.— CHANCRE AND CHANCROID, OR VENEREAL 

AFFECTIONS. 

The effects of venereal diseases are similar on both of the sexes. A 
chancre is a venereal sore which is followed by syphilis. It is a hard 
lump appearing in from two to six weeks after exposure. Its pres- 
ence is often unexpected and sometimes unperceived. It commonly 
exists by itself alone, and secretes a thin, scanty but contagious fluid. 
Occasionally, however, more than one chancre exists at the same 
time. In order to distinguish a chancre from the chancroid it is vari- 
ously called hard, indurated, infecting or Hunterian chancre. It is 
fully described on a following page. 

The term chancroid means like chancre. The chancroid is a con- 
tagious, venereal ulcer or sore, usually situated upon the private 
parts, although it may occur in almost any other situation. It 
secretes a thin pus, which if brought into contact with the mucous 
membrane or an abraded surface, propagates itself by the production 
of other similar ulcers. 

The chancroid has received a variety of names to distinguish it 
from the true or infecting chancre. It is frequently called the soft, 
simple or noninfecting chancre. It has nothing to do with syphilis. 
It is simply a local, inflammatory sore with ragged edges, tending to 
spread rapidly and loath to heal. The soft chancre appears in from 
three to ten days after exposure. It is commonly spread by sexual 
contact, although it may be communicated by means of fingers, 
towels and in various ways. Usually a number of these sores exist 
at the same time. 



X'i'i THE NEW MEDICAL WORLD. 

It is not always easy to distinguish between the soft chancre which 
is simply a local sore, and the hard chancre which is the beginning 
of syphilis. The possibility exists of being inoculated with the 
virus of both, so that where several sores exist one of the number 
may be a genuine infecting chancre. 

TREATMENT. 

A soft chancre, or chancroid when left to itself, tends to spread in 
a destructive way, and a month or two elapses before it runs its 
course and begins to heal. Cleanliness and correct habits are impor- 
tant factors in the treatment of venereal sores. Alcoholic indulgence 
tends to increase their activities and prolongs the healing process. In 
the early stage, the chancroid should be thoroughly destroyed by the 
cautious and thorough application of strong nitric acid to the sore. 
This destroys the ulcerating surface and the infecting virus and 
changes an indolent and spreading ulcer into a healthy sore which 
readily heals. After thorough cauterization, the surface may be 
dusted with iodoform, aristol or iodol, and a cure usually follows 
rapidly. 

IV.— ACQUIRED SYPHILIS. 

Syphilis is a disease due to the action of a specific poison, propa- 
gated by local inoculation. The history of syphilis extends back 
many centuries, and its origin has never been traced. No portion of 
the world occupied by civilized man is exempt from its ravages. It 
is more common, however, in the great centers of population and in 
large cities. It may be acquired in several ways from those who are 
suffering from this loathsome affection, or its subtile poison may 
be inherited from one or both of the parents or other ancestors. It is 
a disease possessing great abilities to do damage and work destruc- 
tion. Its evil progress is not confined to any single tissue of the 
body, but it may invade any or all of them. 

Acquired syphilis is always announced by the appearance of a 
hard lump known as a chancre, usually upon the private parts. 

Between the exposure and the appearance of the hard chancre 
there is usually a period called the incubation, which lasts from two 
to six weeks. Sometime during this period a hard reddish pimple is 
discovered w T hich pursues an indolent course. It does not occasion 
pain usually, nor does it increase rapidly in size, neither does it 



THE NEW MEDICAL WORLD. 4l2o 

occasion any special inconvenience. After awhile other symptoms 
appear. The glands in the groin enlarge and a peculiar copper 
colored eruption of the skin appears. These symptoms come on 
in from one to three months after the appearance of the chancre and 
are known as the secondary symptoms, and unless terminated by 
efficient treatment they last for a year or more. 

In addition to the eruption upon the skin, eruptions are likely to 
appear upon the throat, tonsils, mouth, lips, nose and genital organs. 
The face and scalp are often the site of ulcers and sores which are 
exceedingly annoying to the patient and repulsive to those with 
whom he comes in contact. The mucous patches about the mouth 
and lips are liable to convey the syphilitic poison to others, and it is 
on account of the danger of spreading this contagion that public 
drinking utensils are to be avoided as much as possible. In using 
public drinking cups, rinse them thoroughly if possible, before placing 
them to your own mouth. The act of kissing is not without danger 
if one party is infected with syphilis. 

During the latter portion of the second period the patient is likely 
to suffer from pain in the bones especially at night ; thus sleep is 
seriously interfered with and the general health is deteriorated. 

Syphilis is inclined to pursue a chronic course. It is one of the 
most persistent affections known, and after appearing to be cured for 
years, it may break out afresh on the slightest provocation. When 
the course of syphilis is not arrested by efficient treatment, it may 
harass the patient continually and prove a perpetual annoyance to 
the close of life. 

Many physicians rightly believe that the efficient treatment of 
syphilis, prior to and during the secondary period will effectually 
cure ii and prevent the approach of those more disgusting and per- 
sistent symptoms which characterize tertiary syphilis. When syphilis 
pursues an unmolested course, the tertiary symptoms appear in 
from one to two years. After tertiary syphilis has become perma- 
nently established, its cure is an utter impossibility. 

The unaided system is not able to eliminate the poison of syphilis, 
and if the symptoms disappear for a time they are sure to reappear 
in some other form; for its power for harm appears never to be 
exhausted. The symptoms of tertiary syphilis are so varied, numer- 
ous and well known that few words are necessary to be said 
concerning them. 

Tertiary syphilis attacks the deeper and more vital organs, as the 



424 THE NEW MEDICAL WORLD. 

liver, the kidneys and the brain. The bones are often attacked, 
the destructive process causes ulcerations that are difficult to heal 
and a great variety of abnormal growths and morbid conditions. 

TREATMENT. 

The remedies chiefly relied upon to cure syphilis are mercury in 
some form, and the iodide of potash. Mercury has a specific action 
in arresting the development of syphilis. It must be given in small 
doses as soon as the secondary symptoms appear, and continued for 
a long time ; from one to two years or more. The proto-iodide of 
mercury may be given in doses of one-eighth of a grain in pill form, 
three times a day, or the biniodide in doses of one-sixteenth of 
a grain. A larger or smaller dose may be used if the condition 
of the patient requires. The treatment is tedious and must be con- 
tinued long after the symptoms have disappeared. 

The management of a case of syphilis ought to be intrusted to the 
judgment of a competent medical man, for a very serious affection 
is to be dealt with. In order to effect a permanent cure and fore- 
stall untoward results, the treatment must be faithfully carried out at 
least for two years, and then there is no question but what the suffer- 
ing patient will be successfully and permanently cured. 

Iodide of potash is made use of in tertiary syphilis to check the 
progress of the disease and assist the absorption of nodes and 
nodules. It is often combined with mercury, and after secondary 
symptoms have existed a year or so it is used with great benefit. 
The treatment of mercury and iodide of potash combined is known 
as the mixed treatment. The following is an excellent formula and 
specimen of the mixed treatment : 

^ Biniodide of mercury two grains 

Iodide of potash half an ounce 

Tine, cinchona comp. three ounces 

Peppermint water one ounce 

Mix. Dose one teaspoonful an hour after eating in a wine glass of 
water. This treatment is to be continued for a long time. 

V.— HEREDITARY SYPHILIS. 

Syphilis under certain conditions is wont to blight the progeny 
with fearful destruction descending as a curse from parent to child 



THE NEW MEDICAL WORLD, 425 

with the most disastrous effects. It is the most frequent known 
cause of miscarriage, stillborn children, and of infant mortality, a 
fact well known to all medical men. 

Many believe also that scrofula is due to the remote effects of 
syphilis. The symptoms of hereditary syphilis are very similar to 
that of acquired with the exception that the hard chancre does not 
appear as the initial lesion. These symptoms are the characteristic 
affections of the skin, mucous membrane, bones and other tissues. 
Eruptions often appear, fissures about the mouth and nose, emacia- 
tion, swellings, tumors and chronic inflammations. The sight, the 
hearing, the teeth, the bones and any other part of the body may be 
involved to a greater or less extent. 

Children inheriting syphilis are liable to eruptions, hydrocephalus 
tuberculosis, marasmus and many other diseases Avhich it is needless 
to enumerate. 

The treatment of hereditary syphilis is similar to that of acquired 
and is often attended with the most happy results. Nursing babies 
are benefited by the administration of remedies to the mother 
through the medium of the mother's milk. 

A person who has had syphilis ought not to marry until a year 
after every trace has disappeared. Such a course would reduce to 
the minimum the risk of transmitting syphilis. 



VL_GOXORRH(EA, URETHRITIS, OR CLAP AKD ITS 

COMPLICATIONS. 

Urethritis is either a simple or a specific inflammation of the 
urethra. The specific is otherwise known as gonorrhoea or clap. 

Gonorrhoea is an acute, contagious inflammation of some portion of 
the mucous lining of the urethra in the male or the vagina and 
urethra in the female. The inflammation is accompanied by a fluid 
discharge of a whitish color, about the consistency of cream. This 
loathsome disease is produced by contagion and chiefly by impure 
contact of the sexes. 

It is a local disease running a definite course, and tending toward 
recovery, though in some cases the recovery is retarded for several 
weeks or even months. The period which elapses from the time 
of the exj)osure to the outbreak of the disease is from three to five or 
more days. This period is designated as the incubation. 



426 THE NEW MEDICAL WORLD. 

SYMPTOMS. 

The first symptom is usually an itching about the urethral orifice. 
The passing of water, urination, is attended by a burning or smarting 
pain. After a short time the flow of a thick, whitish fluid is estab- 
lished. There is swelling, redness, soreness, and perhaps pain in the 
private organ or penis. These symptoms are more or less marked in 
different cases. In the female the seat of the inflammation is chiefly 
in the vagina, and occasions much less inconvenience and anxiety 
than in the male. 

TREATMENT. 

The treatment most highly and heartily recommended is preventive. 
There is nothing in a strictly continent course of life which is incon- 
sistent with or antagonistic to good health. This fact needs to 
be widely known, thoroughly taught and persistently emphasized. 

Having contracted this loathsome disease, rest in bed should be 
maintained during the severity of the inflammation, as going around 
aggravates the pain and retards recovery. Attention should be given 
to the diet. It should be light and unstimulating and consist of 
milk, broths, toast, stale bread, crackers and similar articles which 
characterize a mild regimen. Meat for the most part should be dis- 
carded. Tobacco should be restricted and alcoholic liquors ought 
not to be allowed. 

Bathing the inflamed parts in hot water soothes the pain, relieves 
the soreness and reduces the swelling. This treatment may be used 
freely and always with comfort to the patient. Some benefit may 
be derived from drinking flax seed or slippery elm tea. When much 
discomfort attends and follows urination, the following affords relief. 

5, Bicarbonate of potash four drams 

Tine, hyoscyamus four drams 

Syr. of orange peel two ounces 

Wintergreen water two ounces 

Mix. Dose one teaspoonful every four hours in water. 

After a few days the discharge becomes thicker, of a greenish 
color, and appears more purulent in character. There may be con- 
siderable elevation of temperature and other symptoms of general 
malaise. The acute stage of the disease lasts from one to two 
weeks, then a decline takes place. The discharge becomes thinner 



THE NEW MEDICAL WORLD. 427 

and finalty disappears, except perhaps, that it is still noticed in the 
morning. This under proper treatment soon disappears and the 
disease is cured. 

The following prescription may be successfully used for the acute 
stage of gonorrhoea : 

Ijfc Carbonate of magnesia two drams 

Oil of cubebs one dram 

Balsam copaiba one dram 

Oil sandal wood one dram 

Mix. Make sixty pills. Dose two every four hours. 

Astringent injections have been much used and often abused in the 
treatment of gonorrhoea. In mild cases they are unnecessary, and in 
all cases unneeded till after the acute stage has passed. 

The following is a good sample for injection : 

fy Sulphate of zinc one grain 

Acetate of lead one grain 

Ext. hydrastis (discolored) one dram 

Water seven drams 

Mix. Inject a small syringe full two or three times a day e 

The usual duration of an attack of gonorrhoea is about three 

weeks. It may continue much longer, and when improperly treated 

has been known to last for several months. 

Orchitis. — There are numerous complications which may result 
from an attack of gonorrhoea. Orchitis, as a complication, does not 
differ from the same disease due to injuries or other causes. 

In this case the inflammation extends from the urethra till it 
reaches the testicle, where it may cause an inflammation of the 
duct, epididymitis, or an inflammation of the testicle itself, orchitis. 
For treatment see affections of the male genital organs. In addition 
two drops of tincture of pulsatilla may be given every hour. 

Bubo. — Bubo is an inflammation of the glands in the groin. 
These swellings sometimes suppurate. When pus has formed, the 
abscess should be opened and the cavity washed out with an antiseptic 
fluid, after which it should be dusted with aristol or iodoform and a 
pad of iodoform gauze placed over it and held in position as a dress- 
ing. In the early stage before the formation of pus spirits of camphor 



428 THE NEW MEDICAL WORLD. 

are an excellent external application to abort it. Bubo not only 
complicates gonorrhoea but is a frequent complication of chancroids. 
Venereal diseases, although loathsome and disgusting at the best, 
are quite amenable to proper treatment. 

Chordee. — Chordee is sometimes a very painful and persistent 
affection due to the irritation awakened by an attack of gonorrhoea. 
It can be relieved by the following prescription. 

5, Pulv. camphor twenty grains 

Ext. hyoscyamus ten grains 

Ext. opium ten grains 
Mix. Make into twenty pills. 

Dose one at night on retiring and repeat toward morning if 
needed. This complication is also relieved by suppositories. For 
formula see treatment of acute and chronic cystitis. 

Qleet. — When an attack of gonorrhoea is neglected or for any 
reason is long continued, the discharge becomes thin and colorle3s 
resembling glycerine and is known as gleet. When gleet persists, 
it usually indicates stricture of the urethra. The following prescrip- 
tion is appropriate for chronic gleet : 

5, Tinct. cantharides one half dram 

Muriate tinct. of iron one ounce 

Mix. Dose one-fourth of a teaspoonful three times a day in 
water. 

Stricture. — In severe or protracted cases of gonorrhoea the 
mucous lining of the urethra becomes contracted in the process of 
healing and cicatricial tissue is formed, which obstructs to a greater 
or less degree the caliber of the canal. In some cases the urethra is 
almost completely obstructed, so that the urine passes in a dribbling 
stream or drop by drop. 

Usually a stricture can be treated successfully by dilatation of the 
canal with steel sounds of different sizes. An ingenious instrument 
has been invented to cut through or stretch a close stricture. 

Such injuries may result to the organs of generation from an attack 
of gonorrhoea as to prevent procreation. 

Gonorrhoea! Rheumatism. — A peculiarly distressing kind of 
rheumatism is a frequent complication of an attack of gonor- 



THE NEW MEDICAL WORLD. 429 

rhoea. Severe pains and tenderness of one or more joints come on 
during the late stages of the disease. The ankles and knees are the 
joints most frequently affected. This complication is sometimes so 
desperate as to endanger life and no more obstinate grade of rheu- 
matism is ever encountered. 

Purulent Ophthalmia. — Those afflicted with gonorrhoea should 
be careful not to inoculate the eyes with the poison virus as may be 
done by soiled towels or fingers. This affection is sometimes followed 
by blindness. It is mentioned elsewhere. See diseases of the eves. 

It is important to say that stricture and orchitis often result from 
the prescriptions of druggists and incompetent persons who attempt 
to prescribe for gonorrhoea. 



CHAPTER XXVI. 
THE FEMALE GENITAL ORGANS. 



I. — Description of the Female Genital Organs. 1. The 
Female Pelvis. 2. The Ovaries and their Functions. 
3. The Fallopian Tubes. 4. The Uterus or Womb. 
II. — Menstruation and its Disorders. 1. Menstrua- 
tion. 2. Delayed Menstruation. 3. Profuse Men- 
struation. 4. Cessation of Menstruation. 5. Care of 
Menstruation. III. — Affections of the Female Gen- 
ital Organs. 1. Pruritus, or Troublesome Itching. 
2. Leucorrhoea, Whites, Female Weakness. 3. Gon- 
orrhoea in the Female. 

I.— DESCRIPTION OF THE FEMALE GENITAL ORGANS. 

THE Female Pelvis. — The female pelvis differs somewhat from 
the male, the bones are lighter and more expanded, making the 
hips prominent. It is owing to this fact that the motion of the 
female in walking is quite characteristic. 

While the female is not so well adapted to walking or running as 
the male, the shape of her pelvis and the organs contained therein, 
especially fit her for the performance of those peculiar functions of 
reproduction which are essential to the perpetuity of the race. 

The Ovaries and their Functions — There are two ovaries, one 
on each side of the womb, situated in the folds of the broad liga- 
ments. They are about an inch and a half long and less than 
an inch in diameter. They resemble the testicles of the male in 
size, shape, and somewhat in their development and functions. They 
contain numerous little bodies known as Graafian follicles, in which 
an ovum, or egg^ is ripened at regular intervals. 

Each ovary contains several thousand immature ova, many of 
which never reach maturity, but some are in different stages of 



THE NEW MEDICAL WORLD. 431 

development preparatory to their expulsion. The human ovum is 
very small. It does not measure over jfa of an inch in diameter. 
At each menstrual period a single ovum is usually matured, the 
ovaries alternating. When each ovary matures an ovum at the 
same time should pregnancy follow, the result would most likely be 
double pregnancy or twins. 

Each month attending ovulation is a sensitive condition of the in- 
ternal surface of the womb, and should impregnation take place the 
womb is thus prepared for undertaking the nutrition and develop- 
ment of a foetus. Blood flows from the internal surface of the 
womb during ovulation for several days. This process is known by 
various terms as the courses, menses, or in medical language as 
menstruation or the catamenia. 

The Fallopian Tubes. — The Fallopian tubes are the permeable 
ducts which convey the ovum to the uterus. They are about four 
inches long. Their distal ends are little cups surrounded by a fringed 
border called the fimbriated extremity which possesses the peculiar 
faculty of attaching itself to that portion of the ovary where the 
ovum is about to be expelled. This little cup shaped extremity 
catches the matured ovum from whence it is conveyed to the uterus 
where, if previously impregnated, it finds a permanent home and all 
necessary conditions for its development. 

Impregnation is believed to take place most frequently somewhere 
on the journey of the ovum through the Fallopian tube. Sometimes 
though rarely the ovum fails to be grasped by the fimbriated extremity 
and is dropped into the abdominal cavity. This accident is the 
cause of what is known as extra uterine or abdominal pregnancy 
in case impregnation has taken place. 

The Uterus or Womb. — The uterus is a hollow, muscular, pear- 
shaped organ situated in front of the rectum and behind the blrdder. 
Above it rests the intestines while its lower portion rests upon and is 
supported by the walls of the vagina. The vagina is a distensible 
canal of from three to five inches long. The womb is held somewhat 
loosely in position by the broad and round ligaments. These liga- 
ments are capable of permitting marked alteration in the position of 
the womb, as is required in pregnancy, and it is owing to this fact 
also, that displacements of the womb are more liable to occur than of 
any other organ. 



432 



THE NEW MEDICAL WORLD. 



The broad ligaments are composed of folds of the peritoneum. 
They extend outwards from the uterus on each side enclosing the 
Fallopian tubes and surrounding and holding the ovaries also in posi- 
tion. Folds of peritoneum attach the womb to the bladder in front 
and to the rectum behind. The round ligaments are two round cords 
four or five inches long which extend outward through the folds of 
the broad ligaments and downward until lost in the tissues of the labia. 




The uterus and adjacent tissues : a, the upper part of the vagina laid open to show 
internal appearance and mouth of the uterus ; b, mouth of uterus at upper termination of 
vagina ; c, the fundus or body of uterus ; d, the cervix or neck of uterus ; e, line showing 
the removal of the peritoneal covering from the right side of the figure ; f , f , the round 
ligaments ; g, g, the broad ligaments which give lateral support to the organ ; h, the fringe- 
like extremity of the Fallopian tubes ; j, j, the Fallopian tubes ; k, k, the ovaries. On the 
right side of the figure the fringe-like extremity is closely applied to the ovary as when an 
ovum is ready to be discharged. 



The upper portion or larger end of the uterus is called the fundus 
and the lower end is called the cervix while the canal which leads 
into it is the os uteri or mouth of the womb. The cavity of the 
uterus extends from the cervix to the fundus, and on each side of the 
fundus is the small opening of the Fallopian tube. The uterine 
cavity is capable of great distension and is thus admirably fitted for 
the process of reproduction. It enlarges during this process in order 
to accommodate the development of the product of conception to a 
couple of pounds or more in weight. 

The nerve and blood supply of these organs are from several 
different sources and calculated to be as abundant as any occasion 



THE NEW MEDICAL WORLD, 433 

may require. It is owing to this fact largely that derangements of 
these organs are numerous and occasion a great variety of troublesome 

symptoms. 

II.— MENSTRUATION AND ITS DISORDERS. 

Menstruation. — Menstruation attends ovulation. It occurs in the 
mature female every lunar month, or once in about twenty-eight 
days, although slight variations are consistent with health and unim- 
portant. Menstruation is commonly established between thirteen 
and fifteen years of age, but there are many exceptions. It may 
occur as early as eleven, or even earlier, and is frequently delayed 
till the eighteenth or nineteenth year, especially in cold climates. 
Warm climates and the excitements of fashionable life tend to 
hasten this well marked sign of maturity. 

When menstruation occurs, many changes are observed in the 
habits, disposition, behavior and form of the young female. She 
ceases to be a romping girl, becomes modest, coy and ladylike, taking 
much care of her manners and personal appearance. It is noticed 
that her hips have become extended, that her form is more rounded 
and that her ways are more graceful and attractive, in other words, 
she has forever passed from girlhood to womanhood. 

Normal menstruation is attended only by slight inconvenience, as 
perhaps headache, backache and some unimportant nervous symptoms 
caused by the congestion of the genital organs but these symptoms 
usually disappear when the flow becomes established. 

Some females suffer from severe pain in the back or abdomen, 
heaviness and profound nervous symptoms previous to the establish- 
ment of the flow. When the pain is severe or the flow very scanty, 
absent or excessive, some disorder of the natural functions exists 
which should be ascertained and remedied. The amount of flow 
within the limits of health varies from two to ten ounces. 

Delayed Henstruation. — Delayed menstruation in young females 
often indicates that the genital organs have not sufficiently matured 
for the performance of this function. It is poor jDolicy to attempt to 
coerce nature. Such measures should be adopted as will improve the 
vigor of the feeble, anemic, or those otherwise deficient in physical 
development. Better results are obtained from common sense 
measures than from the administration of forcing medicines. A 
nutritious diet, exercise in the country or at the seaside, gymnastic 



434 THE NEW MEDICAL WORLD. 

practices suited to the strength, and flannel or silk worn next to the 
skin are recommended as general measures calculated to improve the 
physical condition at this important period. 

When the young female is pale and the condition of well-marked 
anaemia is present, suitable tonics to improve the appetite and iron in 
small doses to enrich the blood, are suggested as in the treatment of 
anaemia, which see. 

Profuse rienstruation. — Profuse or too frequent menstruation 
indicates in some cases a lax and weak condition of the uterus, a con- 
dition which sometimes follows labor or abortion, or a succession of 
rapid pregnancies or abortions. Profuse menstruation occurs in cer- 
tain abnormal conditions, as when a tumor or growth exists within 
the womb. The affection is rare in young females who have never 
borne children. 

Excessive hemorrhage is debilitating from whatever cause, and when 
it exists for any length of time or is repeated at frequent intervals, it 
ought to receive careful attention. It should be borne in mind that 
what would be considered a scanty flow in one woman would rightly 
be considered excessive in another, each woman having individual 
peculiarities not to be overlooked. A full-blooded, plethoric woman 
would be benefited by a flow which would be too prostrating for a 
woman of the opposite type. When a uterine tonic like the fluid 
extract of ergot in half teaspoonful doses every two or three hours 
fails to relieve this condition, the pelvic organs should be explored to 
ascertain the cause. 

Cessation of Menstruation. — Menstruation ceases temporarily 
during pregnancy and the whole or early part of lactation. The 
cessation of menstruation between the ages of forty-five and fifty is 
known as the change or turn of life and after this the power of 
reproduction is lost. This period in medical language is known as 
the climacteric or menopause. 

Menstruation does not terminate abruptly but there is usually a 
long period in which the courses become scanty or excessive and 
irregular, a period in which are experienced many varied symptoms, 
as headache, backache, hot flashes, faint spells, nervous irritability 
and other derangements of the health. Pregnancy is quite rare 
after forty-five and occurs only in extreme cases after fifty. 

After the change of life there are certain organic diseases, as 
cancer of the womb and breasts which are more liable to appear and 



THE NEW MEDICAL WORLD. 4o"> 

a few previously existing diseases may become aggravated. When 
proper attention is given to this important period, the change of life 
is likely to be passed in safety and the subsequent health to be much 
improved, 

Excitements are to be avoided during the change of life, and the 
sexual organs should enjoy perfect physiological rest. Digestion and 
nutrition should receive appropriate attention. Sleep should be 
abundant and exercise moderate, but persistent. The mind should 
be occupied with cheerful thoughts and not give way to melan- 
choly. 

It can hardly be expected that a complete line of treatment will be 
suggested for all the complex and varied disorders of the female 
genital organs. The most that can be attempted is to advise with re- 
spect to diet and nutrition, rest and freedom from excitements, and 
insist upon those general measures which will tend to prevent irregu- 
larities and preserve the genital organs in a normal and healthy con- 
dition. 

From the anatomy and physiology of the pelvic organs the intelli- 
gent female ought to infer that lacing and tight clothing are injurious. 
They favor congestion and displacement of the womb, they obstruct 
the circulation, diminish the respiration, and are prominent factors in 
female weakness and debility, the effects of which are especially 
marked upon these organs. 

Care During Menstruation. — Suitable attention should be 
given to the health during menstruation, for this function in the civi- 
lized world is especially liable to be disordered, and the prevention of 
such disease as may result therefrom is much more satisfactory than 
its cure. Many diseases of the female organs are the result of igno- 
rance or neglect. During menstruation no carelessness should be 
permitted. Exposure, getting wet, getting the feet wet, or taking 
cold, may cause congestion of the genital organs and result in serious 
consequences. 

Excitement, fatigue, drinking ice water, bathing in cold water or 
dancing may tend to increase or suppress the now and result in 
inflammation of these organs. In many females of imperfect health 
rest for a day or so during menstruation is of great advantage and 
essential to the continuation of their well being. The amount of 
rest needed depends upon the condition of each individual case. 
The diet should be rather lighter than usual. A warm foot 



436 THE NEW MEDICAL WORLD. 

or hip bath is sometimes beneficial to assist in relieving the un- 
pleasant early symptoms and aids in the establishment of the flow. 



ILL— AFFECTIONS OF THE FEMALE GENITAL ORGANS. 

Pruritus or Troublesome Itching. — This is a troublesome affec- 
tion of the external genital organs due to a disturbed condition of 
the nervous system. It may be slight or so troublesome and 
persistent as to occasion loss of sleep and endless annoyance. 

It is often worse at night and the duration of the affection cannot 
be foretold. In some cases it is especially obstinate and lasts foi 
years. The only symptom of importance is a troublesome itch- 
ing and an almost uncontrollable desire to relieve it by rubbing 
or scratching. The remedy suggested by instinct affords only the 
most temporary relief and in the long run tends to aggravate the 
trouble. Scratching or rubbing draws an increased blood supply to 
the already sensitive parts, causes a thickening of the skin and favors 
the development of an eruption. It also adds to the trouble by 
further disturbing the sensitive cutaneous nerves and helps in various 
ways to aggravate a disagreeable condition. 

Irritating discharges may be a factor in the development of 
pruritus and should receive appropriate attention. Cleanliness is 
within the reach of every one and ought not to require a physician's 
suggestion to render its employment popular. Vaginal injections of 
astringent lotions or of water alone may be frequently employed 
in addition to sponging the external surfaces with the same. 

Treatment. — After thoroughly cleansing, the following ointment 
may be applied. 

F£ Menthol half a dram 

Carbolic acid twenty grains 

Aqua rose ointment one ounce 

Vaseline one ounce 
Mix, Apply as needed, especially at night. 

The following is an excellent remedy. 

1} Acetate of lead one dram 

Carbolic acid one dram 

Tinct. opium one ounce 

Rose water two pints 



THE NEW MED* A I. WORLD. 487 

Mix. This solution is to be applied by means of a piece of soft 
muslin. The following has succeeded in some obstinate cases: 

$ Bichloride of mercury half a dram 

Tinct. opium one ounce 

Water eight ounces 

Mix and apply two or three times a day. Label poison. 

When other remedies have failed, this may be tried with good 
hope of success. 

R Chloroform two drams 

Oil bitter almonds two ounces 

Mix and apply as needed. 

In some of these cases the general health needs attention. Tonics 
containing iron and strychnia work well in a large majority of cases. 
When the trouble is due to a disturbed condition of the nervous 
system, the following will render invaluable service. 

R. Fowler's solution one and a half drams 

Elix. Calisaya four ounces 

Mix. Dose one teaspoonful after meals. This prescription is for 
adults but may be used for young persons after suitable reduction. 

Leucorrhoea, Whites or Female Weakness. — This is a common 
affection resulting frequently from some impairment of the general 
health. It is to be regarded as a symptom of some disease rather 
than a disease itself. 

Leucorrhoea is a mucous discharge, more or less copious, from the 
glands of the vagina and cervix. It is often temporary from slight 
congestion of the mucous surfaces or a mild grade of inflammation. 
It often follows or precedes menstruation and occurs frequently during 
pregnancv. When persistent, it is a symptom of disease either of 
the vagina, womb or Fallopian tubes, and it is then necessary to 
investigate these organs in order to learn its origin or treat the 
affection intelligently. 

It should be known that a thin, watery discharge, with offensive 
odor, takes place in cancer of the womb. When a tumor or poly- 
pus exists in the uterus hemorrhage, more or less profuse is a charac- 
teristic symptom, while pus, more or less tinged with blood, suggests 
discharge from an ulcer or absce--. 



438 THE NEW MEDICAL WORLD. 

A slight discharge of mucous of temporary character, requires 
little notice except the suggestion of cleanliness. Assistance is not 
usually sought unless the discharge is profuse, persistent and annoying. 

Treatment. — Persistent and severe cases are likely to resist the 
action of remedies. Ordinary cases of this affection are relieved by 
injections of tepid water, to which may be added such astringents as 
witch-hazel, alum, sulphate of zinc, or the glycerite of tannin, in 
suitable proportions. A heaping teaspoonful of pulverized alum to 
a pint of water makes a simple and convenient astringent wash. A 
tablespoonful of extract of witch-hazel or a teaspoonful of tannin 
previously dissolved by means of heat in half an ounce of glycerine 
and added to a pint of water, make applications equally beneficial. 
When a case of leucorrhcea does not yield to these simple remedies 
advice with regard to it should be sought. 

When bloody pus is contained in the discharge, or an unpleasant 
odor is perceived, a wash containing a teaspoonful of carbolic acid to 
a pint or quart of water is appropriate. In using such a wash care 
should be taken to thoroughly mix the acid with the water. 

A leucorrhoeal discharge may be kept up by the irritation of a dis- 
placed womb, which will need to be rectified before a permanent cure 
will result. Constipation of the bowels is a frequent source of an- 
noyance in nearly all pelvic troubles and should be remedied. The 
general condition may need attention. Many of these cases are in a 
run down condition and require tonics to improve the health. 

It ought to be mentioned in this connection that leucorrhcea may 
prevent reproduction and be the sole cause of sterility. Directions 
for treating other diseases of the pelvic organs, such as tumors of the 
womb and ovaries, displacements, ulcerations and cancers, belong to 
the domain of surgery, and are intentionally omitted. 

Gonorrhoea in the Female. — The general subject of gonorrhoea 
has been fully discussed. See previous chapter. The greater portion 
of what has been said applies to this loathsome disease in either sex. 
There are a few differences, however, which should receive mention. 

There is always a possibility of contracting gonorrhoea innocently, 
and females are more often the victims of this unfortunate occur- 
rence than males. An aggravated leucorrhoeal discharge is some- 
times mistaken for gonorrhoea, and may become the cause of 
unjust suspicion. Hence the wisdom always of a guarded profes- 
sional opinion. 



THE NEW MEDICAL WORLD. 439 

Peritonitis is an additional complication which may result from 
gonorrhoea in the female. The inflammation may travel up the Fal- 
lopian tubes to the peritoneum. When it occurs, it is to be treated 
the same as peritonitis from other causes, with rest and anodynes 
sufticient to allay pain. Pelvic abscess, or abscess of the labia may 
result from this affection. 

Gonorrhoea may so injure the generative organs as to destroy their 
functions and j^revent the possibility of maternity There is no more 
important requisite of treatment for gonorrhoea in the female than 
cleanliness, and this is readily accomplished owing to the access of 
the involved tissues. The irritating discharge should be washed 
away two or three times a day with tepid water and once a day the 
following astringent injection should be used. 

^ Pulv. alum one dram 

Sulph, of zinc half a dram 

Borax ten grains 

Mix. This makes one powder for a vaginal injection to be dis- 
solved in a pint or more of warm water. In ordinary cases this 
treatment is sufficient, if used daily 



CHAPTER XXVII. 
CHILDREN'S DISEASES. 



I. — Chicken Pox or Varicella. II. — Croup, True or Mem- 
branous. III. — Croup, False or Laryngismus. IV. — 
Cholera Infantum or Summer Complaint. V. — Diph- 
theria. VI. — Measles or Rubeola. Measles, German 
or Roseola. VIII. — Mumps or Parotiditis. IX. — Scar- 
let Fever or Scarlatina. X. — Whooping Cough or 
Pertussis. XL — Disinfection During and After Diph- 
theria and Scarlet Fever. 

I.— CHICKEN POX OR VARICELLA. 

THIS is a mild contagious disease occurring chiefly among children 
under twelve years of age. It is accompanied by slight fever 
and an eruption which resembles that of small pox. It is caused by 
disease germs. 

SYMPTOMS. 

The first thing that attracts attention to the disease is the breaking 
out of an eruption which may be scanty, or extend over the whole 
body. 

Vesicles soon form, containing a thin, watery fluid. In a day or 
two they dry in the center and a brown, umbilicated scab or crust is 
formed, which falls off in the course of two or three days, leaving 
underneath a reddened surface and a superficial scar which usually 
disappears after a few days, except in severe cases, when it may last 
longer. These vesicles are not in the same condition, but are in every 
stage of development, and this fact distinguishes the eruption from 
small pox or varioloid. Some are a red spot, still unformed ; others 
have reached a more advanced stage and contain fluid, while others 
are drying up, revealing a scab. In small pox all the vesicles are in 
the same stage of development. 



THE NEW MEDICAL WOULD. 441 

The vesicles in chicken pox are superficial, while in small pox or 
varioloid they reach down into the connective tissue under the skin. 
The disease is not dangerous and in many cases there is absence of 
all symptoms of sickness except the eruption. Recovery is usually 
rapid and perfect. 

TREATMENT. 

Domestic remedies are sufficient for this mild and harmless 
disease. Warm drinks may be administered to promote sweating, 
when the skin is dry, and the patient feverish. It is unnecessary to 
separate the patient from other children or to disinfect the apart- 
ments beyond the admission of sunlight and fresh air. It is important 
that care be exercised to prevent taking cold. A cold contracted 
might render a very mild disease severe or dangerous. 

II.— CROUP, TRUE OR MEMBRANOUS. 

Croup is an acute inflammation of the windpipe, involving also 
some of the neighboring tissues. With young children it is a fre- 
quent and sometimes a fatal disease. It rarely occurs after the 
tenth year of age. The climate is the chief factor in its causation, it 
being more prevalent in some sections than in others, and in cold, 
damp and changeable weather. Certain families and localities appear 
to be especially subject to it. 

SYMPTOMS. 

The disease comes on stealthily. The symptoms are fever, thirst, 
hoarseness and altered voice. Sometimes the child is able to speak 
only in a whisper. There is a peculiar paroxysmal, sharp, ringing, 
brassy, and frequent cough, which having been once heard is rarely 
forgotten, and the disease may be recognized D3 T hearing it from 
an adjoining room without seeing the patient. The tongue is coated, 
the skin is hot and the secretions are checked. Respiration is ob- 
structed, which at length becomes the most prominent symptom ; 
the child makes a peculiar noise and suffocation threatens, rendering 
the situation dangerous and exciting. If the obstruction is great the 
child clutches at his throat with his hands, is thirsty and drinks 
freely, experiencing no difficulty in doing so. The symptoms are 



-f42 THE NEW MEDICAL WORLD. 

worse at night, but seem somewhat relieved in the morning, which 
inspires hope. On the whole, however, they intensify, the cough 
and thirst are constant ; a little tough phlegm may be expectorated, 
yet the difficulty of breathing increases. In favorable cases the 
cough becomes softer, the false membrane may be coughed up 
entire or in shreds, and improvement rapidly follows. 

In unfavorable cases the symptoms become alarming, the mouth is 
open, the head is thrown back to favor breathing, the lips and ends, 
of the fingers get blue, the pulse become rapid and thready ; air 
enters the lungs with increasing difficulty, and unless relief comes 
from opening the windpipe, tracheotomy, the case becomes hopeless. 
The mortality of this disease, especially among children under 
two years old is considerable. 

TREATMENT. 

It is necessary to recognize the danger early and combat the dis- 
ease before the condition of the patient gets desperate. Prompt 
treatment is successful in a great majority of cases, 

Emetics, in the early stage relax the spasmodic condition and may 
thwart the formation of the false membrane. The syrup of squills 
comp. in small doses of four or five drops, and repeated every half 
hour until nausea and vomiting occur is an efficient household remedy. 
The syrup of ipecac, is a safe remedy to use but is less energetic. 
Powdered alum answers well for an emetic. The vomiting ought to 
be followed by a dose of castor oil sufficient to move the bowels 
thoroughly. Hot cloths wrung out of mustard water and laid upon 
the neck and covered with flannel to keep in the heat are beneficial. 
The temperature of the room should be about seventy degrees and 
ought to contain moisture from steam produced by boiling water or 
slacking lime. 

If the disease is taken in hand early and managed energetically, it 
can be overcome before the appearance of any distressing symptoms, 
but if neglected, less favorable results will be obtained even with the 
aid of all the efficient remedies known to the physician. 

When the disease persists, the possibility of its being laryngeal 
diphtheria should be considered, for many cases of acute inflammation 
of the larynx and trachea formerly believed to be membranous croup 
are now believed to be diphtheria. There is no more dangerous 
form of diphtheria than this, owing to the difficulty in making local 






THE NEW MEDICAL WORLD. 443 

applications. Such cases should be recognized early, treated ener- 
getically and antiseptically with the same remedies as recommended 
for diphtheria, which see. 



III.— CROUP, FALSE OR LARYNGISMUS. 

This disease is due to a spasm of the glottis and neighboring 
muscles caused by some irritation acting upon the nerves of the 
larynx = 



SYMPTOMS. 

The early symptoms are those of having taken cold as in acute 
catarrh. The throat may be red and inflamed, the eyes heavy and 
the conjunctiva congested. There is some cough and slight hoarse- 
ness of the voice with more or less running from the nose. Toward 
evening the cold tightens, the running catarrh ceases, the voice gets 
hoarser and the cough has a croupy sound. In the night the child 
awakens suddenly and makes a loud crowing sound, as if partially 
choked, the air enters the windpipe with considerable difficulty, 
owing to the spasmodic condition of the muscles. In some instances 
it is thought to be due not so much to a sudden cold, as to irritation 
produced by a hearty supper and undigested food in the stomach. 
Under suitable treatment the child gets relief in the course of an 
hour or so and falls asleep, but the barking cough may continue at 
intervals till morning. The children of some families seem to be 
liable to such attacks and it is probable that they have an especially 
sensitive nervous organism. It rarely occurs in adult life. When 
spasm of the glottis occurs in diphtheria, it is of more serious import, 
and has been known to cause death. 

TREATMENT. 

The syrup of ipecac, administered often till nausea and vomiting 
are produced usually relieves. Another handy remedy is Hives' 
syrup, five to ten drops every half hour till relieved. Five grains of 
bromide of j)Otash and one or two grains of chloral dissolved in 
water usually afford relief. 



444 THE NEW MEDICAL WORLD. 

The following prescription is appropriate : 

r} Bromide of potash four scruples 

Chloral sixteen grains 

Paregoric two drams 

Syr. tola. one ounce 

Anise water q. s. to make two ounces. 

Mix. Dose one teaspoonful every hour as needed. 

Children who are accustomed to repeated attacks of false croup 
should be clothed warmly with woolen next the skin in winter, and 
accustomed to exercise in the open air. Tonic remedies are often 
necessary to improve the general condition of such children as 
follows : 

5. Iodide of iron pills, each pill containing one grain 
Dose one pill three times a day, or the following : 

5, Syr. of hypophosphites comp. three ounces 

Dose half a teaspoonful in water, three times a day, after meals. 

IV.— CHOLERA INFANTUM OR SUMMER COMPLAINT. 

This is an acute and often fatal disease which occurs among infants 
and children in the hot weather usually from June to September. 
The higher the temperature, the greater the mortality which this 
disease reaches. Teething and nursing children are especially liable 
to attacks. The chief seat of the disturbance is the stomach, bowels 
and finally the brain. 

CAUSES. 

The two most important factors in the development of this disease 
are impure air and unfavorable hygienic surroundings. In cities 
where population is crowded, ventilation imperfect and the odor of 
cesspools or sewers contaminates the air, the mortality from this 
disease is alarming. Teething in summer disturbs the nervous 
system, impairs the digestion and renders these little patients liable 
to attacks of diarrhoea! diseases. 

Heat debilitates the stomach and disturbs the digestion. It favors 
the fermentation of milk and other food products, and hence it is an 



THE NEW MEDICAL WORLD. 445 

important factor in causing summer complaint. Children brought up 
by hand are in much greater danger from this disease than those 
supplied naturally with the mother's milk. 

Children often thrive on cow's milk and other foods in cool 
weather, but they may be utterly unable to digest them when the 
stomach and bowels are weakened by the debilitating effects of heat. 

SYMPTOMS. 

The onset of this disease may be sudden, or it may be preceded 
by a persistent looseness of the bowels for several days. Nausea 
and vomiting are frequent symptoms. The bowels are tender, loose 
and move frequently. The stools are at first slimy and emit a pecu- 
liarly disagreeable odor. There is marked thirst, and so great is the 
desire for fluid that the danger of over-feeding is much increased. 
The child, after nursing, immediately vomits while at the same time 
movements of the bowels are numerous and attended by severe pain. 

Emaciation progresses rapidly, the countenance has a pallid, 
pinched appearance, the eyes are full and bright and the tissues about 
them sunken. This rapid emaciation is due to the escape of the 
fluids of the body. 

The stools become colorless and sink into the napkin, leaving only 
a slight stain. They are known as "rice water" stools. The urine 
is scanty. Unless the disease is promptly arrested the progress 
of emaciation is rapid, great weakness is observed and collapse comes 
on and foretells the fatal termination. 

In some cases while the degree of emaciation and weakness is ex- 
treme, the child lingers, looking like a living skeleton, and these 
apparently hopeless cases sometimes recover; but whether this 
fortunate result is due to good nursing, skillful treatment or an 
unusual vitality, or all combined, it is difficult to determine. 

The majority of these cases having once reached the desperate 
condition of emaciation outlined above terminate fatally. 

TREATMENT. 

It is important to give attention to preventive treatment. Particu- 
lar attention ought to be given in hot weather to nursing and teeth- 
ing children. Their food ought to receive constant attention and not 
be left to the discretion of hired girls or unskillful nurses. The 



446 THE NEW MEDICAL WORLD. 

quantity and the quality of food and the intervals of feeding, must be 
well regulated, and when milk is used great pains must be taken to 
preserve it from fermentation. A child should not be weaned just 
before nor during the heated term. All mothers who can should 
nurse their babies till they are ten or twelve months old. 

Removal of a child to the pure air of the country will often pre- 
vent sickness in hot weather. Children who are already puny and 
suffering from indigestion, begin to improve almost immediately 
on removal from the stifling atmosphere of the crowded town, and 
this improvement is sometimes so well marked as to be noticed on 
the journey away. The requisites for the health of the little one are 
pure air, pure water and healthy food. It is sometimes advisable to 
undertake the removal of a sick child, the effort being attended with 
surprising benefit. 

Thirst renders the sick child liable to take too much liquid food, 
instead of quenching the thirst with the nursing bottle, a teaspoonful 
of cold water, to which a drop or two of brandy has been added, may 
be frequently given. 

There is no better artificial food than peptonized milk for those 
deprived of the natural breast supply. The process of making is 
simple and as follows : Into a clean quart bottle put a powder con- 
taining five grains of extract of pancreatin and ten grains of bicar- 
bonate of soda ; add first one teacupful of water and after shaking, 
add one pint of fresh milk and again shake the mixture. Then place 
the bottle in water as warm as the hand can bear for twenty minutes, 
then remove and place on ice till needed for use. Powders for pep- 
tonizing milk can be prepared by any druggist, or they can be 
bought by the dozen in peptonizing glass tubes. 

An easier way is, to prepare the milk for the nursing bottle and add 
the powder to the warm food every time before the child nurses. 
The process of digestion will thus go on in the child's stomach, but 
greatly facilitated by the digestive ferment. The simple directions 
for this method are as follows : Put into the nursing bottle one gill 
of fresh cow's milk, one or two tablespoonfuls of rich cream and one 
gill of warm water. Add a little milk sugar and a powder con- 
taining one and one-half grains extract of pancreatin, with four 
grains of bicarbonate of soda. This is to be prej)ared freshly for the 
child at each nursing. 

Some children improve on barley gruel, to which a small amount of 
fresh milk is added, both being boiled together for a minute or so. 



THE NEW MEDICAL WORLD. -147 

In making barley gruel, it is necessary to boil the grain for a long 
time. In some cases it is advisable to remove the milk altogether 
for a few days and substitute peptonized beef, or some other nutritious 
food. Sick children should wear thin flannel next to the skin in 
summer, and this precaution will prevent injury from changes of 
temperature, such as are experienced in removal to the country. 
When a child is taken away from the city, it ought to stay away 
until cool weather. 

It is almost impossible to outline a treatment for cholera infantum, 
so much depends upon the necessities of each. case. In the begin- 
ning, it is often beneficial to administer a mild cathartic, to clean 
out all irritating substances from the bowels. The following will 
serve an admirable purpose. 

B Castor oil two drams 

Paregoric two drams 

Syr. acacia one ounce 

Cinnamon water one ounce 

Mix, Dose one teaspoonful every two hours to a child two years 

old, others in proportion. 

When vomiting is persistent give the following : 

1^, Carbolic acid two drops 

Water ten teaspoonfuls 

Mix. Dose a teaspoonful as often as vomiting occurs. 
The following may be used to allay irritation and ease pain : 

I£ Ext. opium one- half grain 

Ext. belladonna one-half grain 

Cacao butter q. s. to make twelve suppositories 

Introduce one into the rectum every four hours. 

Bismuth is a valuable remedy and may be given in five or ten 
grain doses. In place of the suppositories, warm starch water, to 
wdiich has been added from four to ten drops of laudanum, according 
to age, may be used as an injection with satisfactory results. Many 
other remedies have been suggested, but those most suitable for 
domestic use have been mentioned. Hot poultices or liniment 
applied externally over the abdomen afford some relief, 

R Camphor liniment three ounces 

Oil mustard one-half dram 

Mix. Apply externally, on a piece of flannel, as needed. 



448 THE NEW MEDICAL WORLD. 

Lime water, added to milk in the nursing bottle, corrects the acidity 
of the stomach and is a good preventive measure. Vegetable as- 
tringents, such as infusion of red raspberry leaves may be added to 
the milk in suitable proportions. 

In a condition of collapse, hot water bags should be placed to the 
feet and brandy frequently given, or other suitable stimulants. 

V.— DIPHTHERIA. 

Diphtheria is a disease which, although it attacks adults, is more 
common among young persons and children, and for the sake of 
convenience is here classified with children's diseases. 

It is rightly regarded under the best management, as a very serious 
and fatal disease. Many cases are mild and tend to recovery. Some- 
times an epidemic is mild, nearly all cases recovering while another 
epidemic is severe and many cases are fatal. Occasionally, a single 
case only occurs in a family or community, but more often it spreads 
from one to another and from family to family throughout whole 
sections. 

The cause of this disease is believed to be a specific disease germ 
which enters the system in one of two ways, either through contam- 
inated food or infected air. The germs cause fermentation in the 
blood with rise of temperature and lowered vitality. A poison is 
generated in the body which acts upon the nerve forces in a very 
depressing manner, while the site of the local manifestation of the 
disease is usually in the throat, upon the tonsils, or upon the mucous 
membrane in the vicinity. 

Severe cases of diphtheria resemble the condition of blood poison- 
ing more closely than anything else. Upon the throat are discovered 
distinct patches of an ashy colored membrane. These patches are 
adherent, and each one tends to enlarge and unite with others. In 
severe cases, their hold is so firm and deep, as to cut off the capillary 
circulation beneath and produce sloughing of the tissues. It is this 
sloughing process which sometimes produces the fearful odor. 

The glands, in the neighborhood on the sides of the neck and 
under the jaw, swell up and are hard like tumors. These glands 
sometimes turn purple, which is an unfavorable symptom and in- 
dicates a changed condition of the blood. 

Diphtheria is a contagious disease, and a child sick with it should 
be isolated from others to prevent its spread. See disinfection 
during and after diphtheria. 



THE NEW MEDICAL WORLD. 449 

Some authorities describe two varieties of the disease, one called 
false diphtheria. There is but little fever and the child is but 
mildly sick. Health returns after a few days, and there are no 
unpleasant after symptoms, the system being but slightly affected. 
The other variety is more severe in every way. The whole svstem 
seems to be powerfully impressed. There are both local and 
systemic symptoms. Cases of recovery are attended with paralysis 
and other signs of debility, the whole system seeming to be over- 
whelmed with poison of a malignant type. 

TREATMENT. 

This disease should receive early, energetic and skillful treat- 
ment. In order to soften the indurated glands of the neck, applica- 
tions of camphor liniment on a woolen cloth ma} 7 be made to them. 
The following may be used as a gargle and taken internally. 

]J Chlorate of potash one-half dram 

Muriatic acid, (strong) twenty drops 

Water two ounces 

Simple syrup two ounces 

Mix. Gargle a teaspoonful every hour and take a teaspoonful 
internally every two hours. This prescription is known as the 
chlorine mixture. It must be made carefully in order to prevent the 
escape of the chlorine gas, which is antiseptic. 

Formerly the tincture of iron was much used for diphtheria. It is 
not so much used at the present time. It is a good heart tonic and 
in mild cases answers well. 

Chloral hydrate may be used to produce rest. It is mildty anti- 
septic, but in severe cases cannot be relied upon as a germicide. 

fy Chloral hydrate half a dram 

Glycerine one ounce 

Anise water q. s. to make two ounces 

Mix. Dose one teaspoonful every two hours for a child three 
years old. 

Powdered sulphur has been used extensively with good results. 
Some make use of equal parts of sulphur and quinine. Burning 
small pieces of sulphur or roll brimstone on a shovel, by means of a 
hot coal from the fire, carrying it around the sick room, is thought 



450 THE NEW MEDICAL WORLD. 

by some to be beneficial. Care must be taken not to inhale it too 
freely, or to make the fumes too strong for the comfort of the 
patient. Many other remedies have been suggested and tried for 
this disease, but the best ones are those most destructive to germ life. 
The most powerful antiseptic remedy for diphtheria is the bichloride 
of mercury or corrosive sublimate. It is destructive to all forms of 
parasitic or germ existence. It must be used cautiously. It is not a 
dangerous poison in small doses well diluted, as in the following ■ 

5 Corrosive sublimate one grain 

Water three ounces 

Mix. Dose a teaspoonful every two hours or in very bad cases 
every hour. It may be alternated hourly with the chlorine mixture 
previously mentioned. It is claimed for this treatment, that recovery 
takes place without the unpleasant complication of paralysis in any 
of its forms. The use of this remedy is not recommended for domestic 
practice. 

When paralysis occurs during the process of recovery either of 
the vocal cords or other parts, strychnia in doses of one y^- of a grain 
is a remedy of recognized efficiency. It can be obtained in the correct 
adult dose in tablet form, and the dose for children can be regulated 
by dissolving one tablet in from five to ten teaspoonfuls of water, 
giving one teaspoonful of the solution every four hours. 

Many physicians make a free use of stimulants, in all cases where 
the poison of the disease shows a tendency to depress and lower the 
vitality of the system. It is claimed that stimulants are unnecessary 
when the bichloride treatment is carried out. 

*The antitoxine serum has been used with marked success by 
many eminent physicians, who believe that it reduces the death rate 
very perceptibly. The author has tested the antitoxine treatment 
and believes it to be the greatest advance ever made in the treatment 
of diphtheria, having lost no case since commencing its use. The 
internal remedies are given with the same persistency, where the 
injection of antitoxine is used, thereby increasing their efficiency. 
Its use demands professional skill. 

Previous to the use of antitoxine no remedies availed in certain 



•Antitoxine is prepared by treating a young and healthy horse for several months with 
injections of diphtheria cultures, beginning with small doses and increasing them as the 
animal's resistance increases, until the injections cease to produce effect. The horse is- 
then said to be immune, and his blood serum is then known as antitoxine. 



THE NEW MEDICAL WORLD. 451 

putrid or malignant cases. Antitoxine, when injected early enough 
and in sufficient quantity, appears to antidote the septic character of 
the disease, modifying its course. To many, the claim that it is a 
specific, does not seem extravagant. History is likely to rank its 
discovery with that of vaccination for the prevention of small 
pox. 

VL— MEASLES OR RUBEOLA. 

This is a contagious disease caused by exposure to disease germs. 
See bacteria or germs in disease. For two weeks after the exposure 
no symptoms appear and the exposed person feels as well as ever. 
This is the period of incubation. 

SYMPTOMS. 

After the incubative period which may vary a little, symptoms of 
the disease begin to appear and the system is under the influence of 
an advancing sickness. The temperature rises, there is shivering, 
thirst, fever, a coated tongue, watery eyes, running at the nose, 
marked catarrhal affection, dry, hoarse cough, coarse and obstructed 
breathing, headache and loss of appetite. The patient presents every 
appearance of having taken a severe and sudden cold. These symp- 
toms occupy three or four days and this period is known as the stage 
of invasion. 

The stage of eruption which now follows is peculiar and character- 
istic. It appears first.in the mouth and throat, next upon the forehead, 
and soon spreads over the entire body. It consists of dark red or 
purplish spots, slightly elevated, feeling somewhat dry, hot and 
rough to the hand. The rash is coarser and darker colored than that 
of scarlet fever, and unlike it, does not cover the whole body. This 
distinction is usually clear and well marked. The stage of eruption 
lasts four or five days. Before the rash appears, there may be vomit- 
ing; the patient appears drowsy and is inclined to sleep. Convul- 
sions sometimes occur, especially in children. 

The fever does not immediately and wholly decline upon the ap- 
pearance of the rash, but the temperature is likely to remain high for 
two or three days. The urine is scanty and highly colored. The 
whole duration of the disease from the time of the invasion is about 
two weeks. With the fading of the eruption, the severity of the 



452 THE NEW MEDICAL WORLD. 

symptoms decline, the cough loosens, expectoration becomes more 
abundant and the tongue cleans off. 

The final stage is that of desquamation or peeling. The fever 
declines, the rash gradually fades away and the surface of the skin 
peels in little fine dust like scales. 

Army measles, owing to exposure and other causes, have been of a 
very severe and fatal type. Measles without an eruption is a danger- 
ous disease. 

The common complications of measles are bronchitis, pneumonia, 
tonsilitis and affections of the eye. Diphtheria, when it occurs as 
such, is a grave complication. 

Ordinary cases tend to recovery, but complication with pneumonia 
is serious and may require earnest attention to save life. 



TREATMENT. 

This, for the most part, is simple and palliative. There is no 
preventive remedy after exposure. It is very difficult to quarantine 
the disease, because it is largely spread before characteristic symp- 
toms have developed. 

Cleanliness and disinfection of the room occupied by the patient 
are important. The temperature of the sick room should be uniform 
and not above seventy- two degrees. Free ventilation is essential, 
but draughts of air should be avoided, as a cold contracted by the 
patient may be a very serious matter. If the eyes are sensitive 
to light, the room should be darkened. The bedding should be 
comfortable but not too heavy, as it is unnecessary to keep the patient 
in a profuse sweat. 

If the temperature is high, the tincture of aconite may be given in 
drop doses till the skin becomes moist. Cold drinks may be allowed 
in moderation. Cream of tartar lemonade is often very agreeable to 
the patient. 

The diet should be nutritious, but not hearty. Milk, gruel, tapioca 
and similiar foods may be used as required. Complications should 
be met with appropriate remedies. The recovery of those who are 
much debilitated, or who are naturally troubled with scrofula and 
other constitutional diseases may be prolonged. The patient must 
remain in the house till recovery is fully established and avoid exposure 
to cold. Neglect in the after care of measles is the reason why so 



THE NEW MEDICAL WORLD. 453 

many cases develop lung and other diseases. If the cough is trouble- 
some, the following may be used : 

T£ Muriate of ammonia one dram 

Syr. wild cherry one-half ounce 

Syr. ipecac. half an ounce 

Paregoric one-half ounce 

Anise water q. s. to make four ounces 

Mix. Dose one teaspoonful every four hours. Stimulants are 
rarely needed. The application of carbolized oil or vaseline to the 
skin is agreeable. Five or ten drops of the acid to the ounce of 
oil may be used. Should bleeding at the nose occur, a cloth wet 
with vinegar and water and laid on the back of the neck will gener- 
ally relieve it. Vaseline may be used on the margins of the eye- 
lids if they stick together or are inflamed. Cold compresses of 
water and extract of witch-hazel, equal parts, may be used on the 
eyes. If there is much bronchial trouble, cover the chest with 
camphorated oil and place a flannel outside. If convulsions ,occur 
before the eruption, a bath in hot mustard water is advised. After 
removing the patient from the bath, wrap in warm blankets and 
administer bromide of potash. Put one teaspoonful of bromide of 
potash into half a tumbler of water ; dissolve and give a teaspoonful 
every half hour until relieved. Every fourth dose may have com- 
bined with it a grain of chloral. When the temperature is high, 
quinine combined with phenacetine will lower it. 

I£ Quinine thirty grains 

Phenacetine thirty grains 

Mix. Make twenty-four powders or tablets. 
Dose one three times a dav° 



VII.— MEASLES, GERMAN OR ROSEOLA. 

This is a mild, infectious disease, known also as false measles or 
roseola. It is characterized by an eruption upon the skin, resembling 
measles, associated with a slight catarrh and other mild disturbances. 
It occurs but once. It is largelv a disease of childhood, for the 
simple reason that adults having had it previously are exempt. It 
has been regarded by some, as a combination of measles and scarlet 



454 THE NEW MEDICAL WORLD. 

fever. This, however, is a mistake, for it has no relation to either. 

. * 
It resembles measles simply in its spread and mode of contagion. 

The course of the disease is so mild, and its character so simple, that 

it has received far less attention than other contagious diseases. 

SYMPTOMS. 

About two weeks after exposure, an eruption appears upon the sur- 
face of the body, without much of any fever or other indications 
of sickness. The eruption lasts but a short time, varying from a 
few hours to a few days. The rash is less purple than that of 
measles, and less bright than that of scarlet fever. Other mild 
symptoms, may be slight nausea and soreness of tne throat. The 
sore throat resembles that of scarlet fever, but is much less severe. 
The tongue is somewhat coated, and there may be sneezing and 
other catarrhal symptoms affecting the eyes, causing dread of light, 
there is also a mild cough. The temperature is but slightly elevated, 
and all of the disturbances are much milder in type than a case 
of ordinary measles. 

It is rare for the patient to be confined in bed. Little or no 
treatment is required, a mild laxative may be administered and 
simple herb teas, taking care to prevent catching cold. 

VIII.— MUMPS OR PAROTIDITIS. 

This is an acute, contagious disease, characterized by an inflamma- 
tion of the parotid gland, which lies just below and in front of the 
external ear. It is a disease common to children and young persons 
between the ages of two and fifteen years. Infants and old people 
are more or less exempt. The infecting agent or germ, has not yet 
been recognized. Epidemics of this disease are common in the 
spring and fall of the year, proving that cold and dampness have 
some influence in its production. Mumps ordinarily are mild, lasting 
only a few days and tending to recovery. Three stages are noticed. 
The first is the stage of incubation, and lasts from the exposure till 
the occurrence of sickness, a period of about fourteen days. The 
second is the stage of invasion, and lasts from twelve to twenty- four 
hours. The third is the active duration of the disease and occupies a 
period of three or four days. Recovery requires four or five days 
more. 



THE NEW MEDICAL WORLD. 455 

SYMPTOMS. 

The early symptoms are chills of a mild type ; the patient 
appears pale and languid, complains of pain in the head and 
breast, with loss of appetite. Other synDptoms of a marked character 
soon follow. There is rise of temperature ; pain on moving the jaw ; 
and the taking of acids into the mouth produces a peculiar pain. 
Vomiting or diarrhoea, restlessness or convulsions may occur. The 
pain increases if the patient moves the jaw, for the glands swell 
rapidly and form large lumps below the ear, pushing the lower lobe 
outward while the neck and cheeks are involved. 

The swelling may begin first on one side, but during the attack 
both sides are usually affected. If both sides are much swollen, the 
patient holds the head stiffly and is unable to turn one way or the 
other without severe pain. The swollen neck, eyes and cheeks, alter 
the usual expression very much, and the patient, being destitute of the 
usual play of the expression, with the mouth open from which the 
saliva drains away, presents a stupid and almost idiotic appearance. 
Sometimes the amount of swelling is quite extensive. The patient is 
unable to eat, preferring to endure hunger and thirst, rather than 
experience the pain caused by taking nourishment. The tongue is 
coated ; there is an increased flow of saliva ; the pulse is more rapid 
than normal and the temperature is somewhat elevated. 

If the tonsils are also swollen and enlarged, the patient breathes 
heavily and snores when he sleeps. After four or five days these 
symptoms subside, improvement follows rapidly and in four or 
five days more the patient is well. 

Sometimes an abscess forms which opens on the inside of the cheek, 
but this result is rare. The disease is sometimes followed by a second- 
ary inflammation in some remote part, as the breasts and ovaries in 
the female and the testicles in the male. 

TREATMENT. 

The treatment for mumps is simple. Patients should avoid taking 
cold. The diet should consist of beef tea, milk, gruel, broths and 
other suitable liquid food. The bowels should be kept open, using 
the citrate or sulphate of magnesia. Water, ice, lemonade and 
cream of tartar water may be allowed as needed to allay thirst. For 
the fever, tincture of aconite may be given, as in other febrile condi- 
tions, till sweating or moisture of the skin is produced. 



456 THE NEW MEDICAL WORLD. 

Apply the following to the swelling : 

5, Tinct. opium one dram 

Olive oil one ounce 

Mix. Use three or four times a day externally. Hot water dress- 
ings and hot poultices do good. Should the swelling become chronic, 
paint it each night and morning with the tincture of iodine. Hot 
foot baths containing mustard are good in the early stages of the dis- 
ease. In scrofulous subjects, when recovery is prolonged, a one- 
grain pill of the iodide of iron may be used three times a day. 
If much debility follows an attack, cod liver oil is a good remedy to 
build up the system. To the tonsils, if much inflamed, may be 
applied a healing and astringent lotion as follows : 

5, Carbolic acid ten grains 

Glycerine one ounce 

Syr. acacia half an ounce 

Chlorate of potash (saturated solution) two and one-half ounces 

Tinct. of myrrh one dram 

Mix. Gargle the throat every two hours. 

IX.— SCARLET FEVER OR SCARLATINA. 

Scarlet fever and scarlatina are terms applied to the same disease. 
It receives its name from the scarlet color which it imparts to the 
patient. The disease is caused by contagious germs which gain ad- 
mission in some way to the system. It never occurs apart from this 
specific princijrie. It is difficult often to trace it, when it appears to 
break out anew in some community where it has not existed for 
years, but in these cases it has come silently and unbidden, adhering 
to some book, piece of cloth, article of food, clothing or merchandise 
that has come to the family from some infected point. 

This disease has been carried a long distance in a letter through 
the mails and been transported by means of milk from the family of 
the milkman. It may be carried in the hair, the whiskers, the 
clothing or the leaves of a book. The contagious germs may exist 
indefinitely in the meshes of a carpet or adhere to the paper on the 
walls of a room. They may be stored away in the attic with some 
doll or plaything and be brought forth at some future day, as vigorous 



THE NEW MEDICAL WORLD. 4"> . 

as ever, to attack another victim after months or years. This disease 
has a short period of incubation, during; which the patient feels as 
well as ever and has no reason to fear approaching sickness. This 
period varies from one to four days. The period of invasion lasts 
about one day. 

SYMPTOMS. 

The first symptom is usually a chill or chilly sensation, quickly fol- 
lowed by fever, with high temperature and rapid pulse ; the skin 
is hot; the eyes are bright; the pupils enlarged and face Hushed. 
Vomiting is rarely absent ; there is usually great thirst, and some- 
times stupor and delirium. The mouth and throat become rapidly 
inflamed and the papillae of the tongue are enlarged. After these 
symptoms have lasted a few hours the eruption appears. The body 
looks as though it had been reddened with a strong mustard plaster, 
or like a boiled lobster. It is covered with a fine scarlet-colored 
rash, which disajjpears in a line when you draw your finger over the 
surface, but at once reappears. The rash causes a burning or itching 
sensation, very anndying to the patient. The stage of eruption 
lasts from three to six days, but reaches its height on about the third 
day. The temperature goes up to one hundred and one degrees, or 
perhaps as high as one hundred and four in very severe cases. The 
skin is hot ; the lips are dry ; and the patient is restless. The inflam- 
mation in the mouth and throat continue and the patient calls 
urgently and repeatedly for drink. The urine is highly colored. In 
favorable cases, the temperature declines after the eruption is fully es- 
tablished, and marked improvement is manifest. At the end 
of this eruptive stage the rash has faded away ; the redness of the 
mouth and swelling of the throat subside ; the appetite begins to 
return ; the countenance brightens and the child takes an interest 
in objects that he has previously refused to notice. Next follows 
the stage of desquamation or peeling. This lasts five or six days, 
sometimes much longer. The skin peels off from the hands and 
feet in scales. If the rash has been slight, tne peeling process will 
also be slight, but when the rash has been severe, peeling of the 
entire body occurs. There are other types of the disease, more pro- 
longed and severe than that described. This disease has every type 
of manifestation, from very mild, to the most malignant sickness. 

It is hardly to be expected that a severe type of scarlet fever with 
complication^ can be treated with household remedies. The on»et 



458 THE NEW MEDICAL WORLD. 

of this disease is sometimes violent. There is great restlessness, 
twitching of the tendons, sometimes delirium and convulsions. In 
some cases there is irritability of the stomach, and the food and medi- 
cine necessary to sustain the strength and make an impression upon 
the disease are at once rejected. Sometimes the whole force of 
the disease, seems to attack the nervous system and acts with 
frightful energy, prostrating the vital forces with great rapidity, like 
a case of severe blood poisoning. Large swellings may appear on 
each side of the neck. The ear is sometimes involved, and dis- 
charges pus, with destruction of the tissues and loss of hearing. 
Diphtheria sometimes complicates scarlet fever. 

Sometimes the kidneys become more or less disabled and dropsy 
manifests itself. This condition may arise from too early exposure, 
the patient being permitted to leave his room too soon. Albumen 
may appear in the urine and urea accumulate in the blood, presenting 
grave symptoms. Cases otherwise mild, that have progressed favor- 
ably and that have promised speedy recovery, may be complicated 
and the recovery prolonged. The patient should be kept in doors 
and exposure avoided, until full recovery has taken place and the 
stage of desquamation is complete. 

TREATMENT. 

Belladonna has been recommended to prevent scarlet fever, but it 
appears to have no power whatever to do so. The following treat- 
ment is adapted only to ordinary and uncomplicated cases. 

The room occupied by a scarlet fever patient should be well venti- 
lated without subjecting the patient to the danger of catching cold. 
The temperature should be kept at about seventy-two degrees. For 
the throat inflammation the chlorine mixture may be used. See 
treatment of diphtheria. This mixture is to be gargled every hour 
and a teaspoonful taken internally every two hours. Camphora- 
ted oil may be applied to the swollen glands in the neck. Quinine 
and phenacetine may be given to reduce the temperature. See 
treatment of measles for formula. The body may be sponged over 
with warm water and alcohol, after which the itching and burning of 
the skin may be relieved by the use of carbolized vaseline as follows : 

5, Carbolic acid one-half dram 

Vaseline four ounces 



THK NKW MEDICAL WOULD. 4.~)^ 

Mix. Apply over the entire surface of the body as needed to 
relieve the skin of itching. 

The diet should consist of milk, gruel and light articles of food. 
An excellent drink in fevers is made by dissolving a teaspoonful of 
cream of tartar in a pint bowl of hot water, adding lemon juice and 
sugar to taste. Stimulants may be required. Sweet spirits of nitre 
may be used as a diuretic. In cases of threatened dropsy, one-twen- 
tieth of a grain of pilocarpin may be given three or four times a 
day. This remedy causes profuse perspiration and aids the kidneys 
in the work of eliminating the poison. 

In the treatment of scarlet fever the septic character of the disease 
should be borne in mind, and in all severe cases the bichloride treat- 
ment as recommended for diphtheria, alternated with the chlorine 
mixture is appropriate. 

X— WHOOPIXG COUGH OR PERTUSSIS. 

This is an acute contagious disease of uncertain duration, often 
lasting six weeks or' more, depending somewhat upon the season of 
the year. Its course is more brief when contracted in the spring ; 
warm weather and out-of-doors life being favorable to recovery. It 
occurs but once in a lifetime, usually in childhood, but it may be 
contracted by persons of any age. 

SYMPTOMS. 

These are a catarrhal condition of the air passages and a nervous 
paroxysmal cough which is easily recognized. The characteristic 
whoop occurs during the paroxysms of coughing. The cough is 
rapid, the breathing is obstructed by the spasmodic condition at the 
entrance of the windpipe, the child turns blue in the face, the eyes 
arc congested and bulge from the head, and tears flow unbidden from 
the eyes. Previous to a paroxysm of coughing the child usually runs 
and seizes hold of some neighboring object for support. At the 
close of coughing the spasm relaxes and air is powerfully drawn into 
the lungs with a whooping sound. The characteristic whoop may 
occur several times during a fit of coughing. The cough reaches its 
height about the third or fourth week, after which, there is some de- 
cline in its frequency and severity. 

When there are but two or three paroxysms of coughing during 
the day, the case is mild and the health suffers but little. When they 



460 THE NEW MEDICAL WORLD. 

run up to thirty or forty during the twenty-four hours, the case 
is severe and demands earnest attention. Vomiting is common 
during the spasms of coughing, and ruptures have been known 
to result from the severe strain upon the abdominal walls. 

Whooping cough is often a severe ordeal for young persons of 
slender build, or weakly and poorly nourished children. Death rarely 
results from whooping cough, except when there are complications, 
which affect the lungs or brain. Pneumonia is the most unfavorable 
and frequent complication with young children. 

Whooping cough is conveyed from one to another, by contact 
sufficiently close to inhale the breath. The time of incubation 
between the exposure and the appearance of the first symptom is 
from one to three weeks. It comes on like a cold or some catarrhal 
affection. This condition lasts several days, sometimes two weeks, 
during which time the eyes are heavy and the conjunctiva con- 
gested, there is more or less cough and expectoration, with loss 
of appetite and slight fever, as in a case of acute bronchitis. These 
symptoms occur before the character of the disease can be deter- 
mined ; for the paroxysmal cough and whoop are the only symptoms 
which render the diagnosis certain. 

TREATMENT. 

During the catarrhal stage the same remedies may be used as for 
an ordinary cold. Avoid exposure, as colds increase the severity of 
the attack. Should the lungs be loaded with mucous which the child 
is unable to raise, an emetic may be necessary to loosen it. Half 
teaspoonful doses of the syrup of ipecac, will accomplish this result 
without depressing the system. If there is some fever the following 
prescription is suitable to use : 

1} Syr. squill comp. two drams 

Tinct aconite sixteen drops 

Paregoric two drams 

Syr. tolu. half an ounce 

Anise water q. s. to make two ounces 

Mix. Dose : half a teas]30onf ul for a child a year old, increasing or 
diminishing it as age or circumstances require. 

Lobelia has been highly recommended in whooping cough and 
from its antispasmodic action, excellent results may be expected from 



THE NEW MEDICAL WORLD. 4G1 

its use, after the disease is recognized. Thirty drops of the tincture 
may be added to half a glass of water. Dose : one teaspoonful every 
hour or two. It is claimed by some, that quinine in full doses will 
arrest this disease. 

Atropia often acts beneficially. Dissolve one tablet containing 
one y-J-j- of a grain in ten teaspoonfuls of water. Give one tea- 
spoonful of this to a child a year old three or four times a day. 

After the catarrhal stage has subsided, the child should be allowed 
to go out of doors in good weather. One of the best remedies in 
the spasmodic stage is chloral, in small and repeated doses, combined 
with bromide of potash as follows : 

3 Chloral one-half dram 

Bromide of potash two drams 

Syr. tolu. one ounce 

Anise water two ounces 

Mix. Dose half a teaspoonful to a child one year old, and a full 
teaspoonful for a child two years old, and repeat every two or three 
hours as needed. These remedies allay the spasm, relieve the cough 
and favor sleep, and when administered properly, the result is sur- 
prising. In all cases the coming of spring, a change of air or the 
sea air when available, act beneficially. The ammoniacal odors of 
gas works are said to be curative. A spray of carbolic acid solution 
is worth trying. Ten drops of carbolic acid should be added to an 
ounce of rose water and an ounce of glycerine. Spray this frequently 
into the mouth from an atomizer or load the air of the apartment 
with it for inhalation. Cod liver oil in the form of a palatable emul- 
sion is good in cases of prolonged recovery. 

Whooping cough is not only tedious and debilitating, but fre- 
quently fatal to children under two years of age, from some compli- 
cation, hence it is wise to avoid the exposure of such children to it. 
Vaccination, as ordinarily performed, appears to modify the severitv 
of the disease and is worthy of trial. This is probably owing to the 
fact that different disease germs sometimes antagonize each other. 

XI.— DISINFECTION DURING AND AFTER DIPH- 
THERIA AND SCARLET FEVER. 

After diphtheria or scarlet fever has invaded a household, it is 
important to know just what ought to be done to prevent its spread. 



462 THE NEW MEDICAL WORLD. 

The patient should be quarantined in an upper room. The loAver 
rooms will then be comparatively safe. Well children, if possible, 
should be sent away before they have been exposed to the con- 
tagion. If this is impossible they should be kept down stairs and 
away from the sick room. 

They must not be allowed to attend school. The nurse ought not 
to mingle with the other members of the family. As little furniture 
should be allowed in the room occupied by the patient as possible, 
and that of the plainest kind. Carpets and stuffed furniture are to be 
excluded, as they furnish a lodging place for disease germs. The 
sick room should have some arrangement for ventilation, as a board 
placed under the bottom of the window to admit air between the 
sashes in cold weather. In warm weather, freer ventilation may be 
allowed by opening doors and windows, remembering always to 
keep the patient out of the way of a draught. 

Disinfectant solutions should be used freely in and about the 
sick chamber. Cloths wet in these solutions and hung about the 
room are helpful. The patient can be sponged over with alcohol and 
rubbed with carbolized vaseline. This prevents the scales of the 
body from flying about, and is soothing to the patient when there 
is an eruption, as in scarlet fever. 

The bedding, pillow cases, sheets, night dresses and other articles 
worn by and used about the patient should be changed frequently. 
The soiled clothing ought to be put into boiling water immediately 
and boiled for ten minutes. The bed clothing used by the nurse 
should be treated in the same manner. Everything that can be sub- 
mitted to boiling water is rendered safe to use without the addition 
of chemicals, as boiling water destroys disease germs. For the 
discharges of the patient, dissolve two drams of corrosive sublimate 
and two drams of permanganate of potash in one gallon of soft 
water and use as follows. 

Keep a little in the chamber, and when the patient has a movement, 
add to it a pint or more of this disinfectant solution. Let it stand 
for a short time and disinfection will have taken place. A carbolic 
acid or copperas solution should be used in the closet and urinals. 

When the patient has sufficiently recovered, still more thorough 
methods of disinfection should be instituted. Playthings and value- 
less articles or articles of slight value should be burned and never 
thrown into the rubbish or into a running*; brook. Other articles should 
be subjected to the fumes of burning sulphur in a thorough manner. 



THE NEW MEDICAL WORLD. Mui 

Place a tub in the infected room with three inches of water in it. 
Put three or four bricks in the bottom of the tub, and on the bricks 
place an iron kettle. Into this kettle put two or three pounds of roll 
brimstone broken into fragments. Set it on fire by means of coals 
from the stove or a little alcohol and a match. Close the room tightly 
and fumigate it thoroughly for thirty-six hours, then throw open the 
room and ventilate it thoroughly. Afterwards wash the floors with 
hot soap suds. Repaper or repaint the walls and woodwork. Re- 
paper or whitewash the ceiling. This work should be thoroughly 
done in order to destroy the innumerable and invisible germs which 
cause these infectious diseases. In addition to the fumigation of the 
room occupied by the patient, the whole house should be looked 
over, and attention paid to its sanitary condition. Everything in and 
about the house should be cleansed, as furniture, clothing, carpets 
and curtains. The cellar should receive most careful attention. Foul 
air, mould and dust should be cast out. Every room and its contents, 
from attic to cellar, should be cleansed and no dark corner or neg- 
lected spot be allowed to escape. The whole house should be 
cleansed, aired and ventilated. 

Different disease germs require somewhat different methods for 
their extermination, but the same general principles apply to all. 

After small pox it is better to destroy all the infected clothing and 
bedding by fire, as they are not worth the effort which would be 
necessary for their complete disinfection. 

It is believed that under each disease sufficient directions are given 
for proper disinfection in every instance, but diphtheria and scarlet 
fever are diseases of such importance, that a special article on the 
necessary precautions will no doubt be appreciated. See bacteria or 
germs in disease. 



CHAPTER XXVIII. 
FEVERS. 



I. — Bilious or Remittent Fever. II. — Malarial or Inter- 
mittent Fever. III. — Catarrhal Fever, Influenza or 
La Grippe. IV. — Neuralgic Fever or Dengue. V. — 
Typhoid Fever. VI. — Typhus Fever. VII. — Yellow 
Fever. VIII. — Puerperal Fever. 

I.— BILIOUS OR REMITTENT FEVER. 

THIS is a continued malarial fever, due to malarial poisoning, but 
is very severe. The symptoms are influenced by a disordered 
state of the liver, there being an excess of bile which occasions per- 
sistent vomiting, and for this reason it is called bilious fever. It 
prevails in malarial regions in the summer and fall, and manifests 
every type of severity. It is sometimes called typho-malarial fever. 

SYMPTOMS. 

These are fever, hot, dry skin, high temperature, offensive breath, 
a yellow coated tongue, nausea with vomiting, headache and chills. 
The vomited matter is composed chiefly of mucous and bile. On 
alternate days the symptoms usually abate somewhat, the skin 
becomes moist and the temperature declines. On the following day 
another chill occurs, succeeded by a rise of temperature. The patient 
is uneasy and restless at night, tossing and moaning. If the case is a 
grave one, the fever pursues a more persistent course and delirium is 
common. There is often hemorrhage from the nose ; the tongue is 
dry; there is tenderness over the liver and spleen ; the skin has a 
yellow hue, a condition which suggests jaundice, especially noticeable 
in the whites of the eyes. The urine is scanty and very highly 
colored. This condition may persist for a couple of weeks, when the 
symptoms abate in favorable cases, and the patient recovers. After 



THE NEW MEDICAL WORLD. 465 

recovery sores often break out about the mouth and lips. In 
malarial districts this disease is often severe, and takes on a form re- 
sembling yellow fever, which may terminate fatally. 

TREATMENT. 

A generous dose of quinine taken every morning before going out 
of doors is said to prevent attacks of bilious fever. In regions where 
this fever prevails in the fall, and quinine is usually relied upon 
to prevent it, the dose must be generous, five or ten grains each 
morning. When the fever is established it requires the same treat- 
ment as malarial fever or fevers in general. Remedies which act 
upon the liver are beneficial. The following is serviceable : 

fy Quinine one dram 

Salol one scruple 

Podophyllin two grains 

Oleo-resin of ginger ten drops 

Mix. Make into twenty pills or capsules. 

Dose one each night and morning. Acid drinks are often relished 
by the patient, as lemon juice, jelly water, cream of tartar water, and 
other similar and cooling drinks. 

The mineral acids, well diluted, are often made use of in the 
treatment of this fever. Fowler's solution, in three drop doses, is a 
good tonic during recovery, and may be used in connection with 
quinine to prevent its recurrence. 

II.— MALARIAL OR INTERMITTENT FEVER, 

This disease is caused by a specific poison or germ which may 
enter the system in several ways, but chietly by an infected malarial 
atmosphere. It may gain admittance to the system by means of the 
food and water supply, especially water and milk which are contami- 
nated with malarial poison. After a period of exposure of longer or 
shorter duration, averaging about thirty days, the affection begins to 
manifest itself. 

SYMPTOMS. 

The symptoms are many and various, but the following are those 
more common and more readily recognized. The appetite is fitful, 
food producing sometimes a sudden nausea, followed by vomiting 
before the meal is finished. Digestion is deranged : headache is com- 



466 en i: NKW MEDICAL WORLD. 

mon, and pain in the hack, back <)( the neck and limbs or elsewhere 
about the body. The tongue is pale and perhaps coated ; the bowels 
are usually constipated, but sometimes the opposite condition is ob- 
served. Dizziness may occur; the countenance has a sallow look; the 
urine is highly oolored, almost as it' mixed with blood. Chilly sen- 
sations are experienced over the surface of the body, or creeping down 
the spine; the skin is pallid ami little elevations known as goose (lcsh 
may be seen. Yawning may occur and decided shivering. The 
teeth chatter; the patient feels cold and shakes with chills, even 
though warm drinks are taken, hot applications applied externally, 
and blankets multiplied over him. Nausea, and vomiting may con- 
tinue, and the pain in the head and limbs increase. This is a 
description of the cold stage. The symptoms narrated may be more 

or less marked. Other symptoms may be noticed or some i^ those 
enumerated may be wanting. This stage lasts only a short time, 
varying from half an hour to two hours, during which, the circulation 
of the blood is much disturbed. It is driven inward, and with every 
chill there is more or less congestion of the internal organs, while 
the external surface is well nigh bloodless. 

Soon reaction takes place and the patient begins to get warm. The 

blood returns to the surface and the equilibrium is somewhat restored. 

The face, so recently pale, begins to be flushed, the eyes blood shot, the 
veins fill up and appear turgid, the patient complains of headache, 
heat and thirst. The temperature rises rapidly, and the skin is hot 
and dry. Should the temperature run xevy high, there is usually 
marked restlessness and delirium. The patient seems burning with 
lever and calls for cold water, and the bedclothes are thrown off. 
This describes the hot or fever stage, and the two together are known 
as chills and fever, fever and ague or the shakes. The hot stage 
lasts from two to four hours, when profuse sweating followed by a 
decline of the temperature takes place. The delirium disappears and 
the patient feels much relieved, the attack being ended for the 
present, only to return with greater vigor in a couple of days unless 
prevented by treatment. This state of affairs might go on almost 
indefinitely at fixed intervals, but most commonly every other day. 

TREATMENT. 

When the chill follows a hearty meal, if vomiting does not occur 
spontaneously, it is a good idea to unload the stomach with an 
emetic, as digestion is impossible. Warm water, warm mustard 



THE M.u MEDK a I. WORLD. !»'», 

water, or the Byrup of ipecac, are suitable to accomplish this purp 
Blankets should be allowed as desired, and warm infusions may be 
given. Hot cloths wrung from mustard water may be applied over 
the stomach or elsewhere as Deeded. Bottles filial with hot water 
may be placed at the feel or along the spine, to assisl in restoring the 
circulation and give comfort to the patient. Alcoholic Btimulants 
seldom do good, and may do harm. They should not be admin- 
istered unless, for some reason, their use is accessary. 

The best remedy, because the most prompt to relieve the severe 
pain ami distress in these cases, is from one-sixth to one-fourth of a 
grain of morphine combined with atropia ami given hypodermically. 
This goon relieves the pain in all parts of the body. In family 
practice, it may be given by the mouth if the stomach will tolerate 
it, or in place of it a live or ten grain dose of Dover's or Tully's 
powder could he administered with .similar results. To children 
suffering from violent pain, a one or two grain dose of Tully's 
powder may he given; or a cup of herb or ginger tea with a few 
drops of paregoric may be administered. Cream of tartar lemon- 
ade, hot or cold, may be freely used. It favors sweating and in- 
creases the eliminative action of the kidneys and bowels. 

A- Boon as the hot stage subside-, a generous dose of quinine, five 
to twenty grains, may be given to prevent the return of a similar 
or more severe attack. One or two grains three time- a day i- 
sufficient for a child a year old. To Buch patient- it may be given 
with the cream of tartar lemonade or in liquid form as follow-: 

^, Quinine half a dram 

Syr. of liquorice two ounces 

Mix. Dose a tea-poonful three times a day. This makes a palata- 
ble prescription out of a bitter drug. 

After an attack of malarial fever and chills, the patient is usually 
more or less debilitated, and requires the administration of medicine 
to eliminate the remaining poison and restore health. The follow- 
ing prescription i- an excellent one, and has cured many cases debili- 
tated by malarial poison. 

r> Quinine one dram 

Reduced iron ten grains 

Ext. mix vomica four grains 

Podophyllin one grain 

Oleo-resin of dinger ten grains 



468 THE NEW MEDICAL WORLD. 

Mix. Make into twenty pills. Dose one pill three times a day 
after meals. 

The following prescription may be used for children one year old 
and upward, who need building up after attacks of chills and fever. 

I£ Quinia muriate twenty-four grains 

Fowler's solution half a dram 

Elix. calisaya one ounce 

Syr. liquorice two ounces 

Mix. Dose one teaspoonful three times a day after meals. 

III.— CATARRHAL FEVER, INFLUENZA OR LA GRIPPE. 

This is an acute, epidemic, catarrhal fever which at times has 
prevailed over wide sections of the globe, attacking a large number 
of persons almost simultaneously. Its history shows that it is no new 
disease. In the fifth century it prevailed in Europe, and since that 
time its history has been frecpiently recorded. It has always ap- 
proached our own country, advancing from the East. In 1890 it 
swept around the world w r ith great rapidity and again appeared in 
the years 1891 and 1892, rendering its history and course to us of 
universal interest. It prostrated thousands, increased the death rate 
enormously, and left its depressing effects behind it for a long time. 
It paralyzed business to a great extent, and checked the progress of 
many enterprises. Its character at first was but little known. It 
was more carefully studied after its arrival, and proved to be a more 
debilitating and fatal disease than had been supposed. Many people 
in the decline of life succumbed to its ravages. 

SYMPTOMS. 

The symptoms are numerous. The onset is usually sudden, the 
patient being seized with chilly sensations and nervous chills, alter- 
nating with hot flashes and a marked tendency to internal congestion. 
These nervous chills are followed by high temperature, and 
pains of an intense character, as headache, lumbago, pain in the 
limbs and elsewhere throughout the body. The patient is uneasy 
and complains of aching in every bone. The flesh is sore as if it 
had been mauled. Even the eyeballs and the scalp are sensitive to 
pressure and there is often tenderness over the spine. 

The sense of taste and smell may be disturbed. In severe cases 
delirium is common, and in a few instances meningitis or insanity 



THE NEW MXDI4 A I. WORLD. 469 

have been known to result. The disease sometimes begins with 
sneezing, a hoarse congh and other Bymptoms of a sadden cold. 
Tln-re i- a catarrhal condition of the mucous membranes and well- 
marked 1 bronchitis, as in measles. At first the pulse and temperature 
may l»e bat little altered : the patient complains of feeling chilly, even 
when in a warm room or seated near the tire. The intiammation 
of the mucous membranes i- well marked. There i> redness of the 
throat ami bronchial breathing. Acute bronchitis or pneumonia are 
M'lne of the diseases t<> Be most dreaded as complications. Some- 
times there i- constant nausea ami vomiting, ami a tongue resembling 
typhoid fever. The liver i> torpid ami the bowels constipated. The 
skin may be sallow, the eyes yellow, and the urine scanty and 
highly colored. 

In all cases marked nervous symptoms maybe observed. There is 
loss of Btrength, an unexpected ami unaccountable debility, the 
lower limbs being scarcely able to sustain the weight of the body. 
There i- pain at the pit of the stomach, >evere neuralgic pains, with 
well marked prostration ami a peculiar tendency to heart failure 
in >evere cas - 

TREATMENT. 

Thi> disea-e i» modified when treated early and efficiently, and 
it- entire character changed. When neglected mild cases may 
develop into severe ones, and grave complications are liable to occur, 
entailing fatal results. 

Rest should be enforced. This is imperative. The pain must 
receive attention. This sometimes yields to the administration of 
phenacetine or acetanilid in five grain doses, and repeated every two 
or four hours. When the pain is severe and the prostration well 
marked there is no better remedy than morphia. One-eighth of a 
grain maybe uiven by the mouth, or if there is nausea hypodermically. 
In many cases double the amount is required to relieve the pain. 

Morphia i- a powerful nerve stimulant and strengthens the heart's 
action, hence it is the remedy above all others for pain in cases of de- 
pressed vitality. Quinine administered early in full dose may prac- 
tically abort the disease. It maybe combined with other helpful 
remedies a- phenacetine or morphia, thus : 

R Quinine thirty grains 

Phenacetine thirty grains 

Morphine one or two grain- 



470 THE NEW MEDICAL WORLD. 

Mix. Make twelve pills or capsules. Dose one every four hours 
in the acute stage. 

The liver should be gently moved to action by a safe cathartic. 

Expectorants may be needed as in bronchitis. Stimulants may be 
required in cases of excessive prostration, or when the patient is old 
or especially debilitated, or suffering from some other disease, so 
that recovery is retarded. 

Camphor is well spoken of as a stimulant in this disease, and 
opium is a remarkably reliable stimulant to the cerebro spinal nerves. 
Digitalis is a valuable heart stimulant. 

Acetanilid, antipyrine and phenacetine are capable of working mis- 
chief in unskillful hands, but are safe and reliable agents to relieve 
pain and reduce fever if used in the first stages, before the system is 
depressed by the disease. Their effects must be closely watched. 
After effects of the grip require tonics, such as quinine, iron and nux 
vomica, malt and a judicious diet. 

Complications must be met as they arise and a relapse avoided. 
The disease possesses the most danger for old persons of feeble 
circulation and delicate health, and such patients require faithful care 
and attention. Recovery is sometimes retarded by a chronic dis- 
charge of pus from the middle ear, otitis media. 

For an attack in a person of robust constitution the following 
prescription is recommended as combining suitable remedies. 

I£ Quinine sulph. one dram 

Phenacetine two and one-half scruples 

Tully powder two scruples 

Mix. Make into twenty pills or capsules. Dose one every four 
hours. 

A mustard plaster applied over the chest when there is pain or 
hoarseness in that region, or symptoms which indicate bronchitis or 
pneumonia will afford no little relief. The diet should be simple and 
nutritious. 

IV.— NEURALGIC FEVER OR DENGUE. 

This is an acute febrile disease of malarial origin which occurs 
in the southern states. It reached as far north as Philadelphia in 
1780. It resembles "La Grippe" in some respects. It is sometimes 
called breakbone fever. 



THE NEW MEDICAL WORLD. 471 

SYMPTOMS. 

These are chills and fever, flushed face, coated tongue with bitter 
taste in the mouth. Vomiting, diarrhoea and cramps may occur. 
Severe pain is experienced in the knees, ankles, wrists, lingers, toes, 
head and back, with marked soreness of the muscles and joints. 
Whole households are often down with it at the same time. In a 
couple of days the severity of the fever and the intensity of the pain 
subside. After about a week, a rash resembling scarlet fever 
appears, though somewhat darker in color and more in patches. 
Just before the outbreak of the rash the fever returns, but disappears 
ao-ain after the eruption is established. The disease lasts a little 
over a week, and leaves the patient prostrated, with marked symp- 
toms of debility. In young children it may cause convulsions. 

TREATMENT. 

The pain may be relieved by morphia hypodermically or a five 
or ten grain dose di Dover's powder, or for a child, a two to five 
grain dose of Tully's powder, according to the age. A cathartic 
to move the bowels and arouse the liver is essential. Quinine 
should be given freely to allay the fever and antidote the septic 
nature of the disease. 

For itching of the skin, carbolized water or vaseline, ten or twenty 
grains to the ounce, affords relief. For subsequent debility, use the 
medicines recommended for debility following La Grippe. In 
the fever stage the prescriptions given for the treatment of malarial 
and catarrhal fever are appropriate, and need not be repeated. 

V.— TYPHOID FEVER. 

This is an acute, infectious disease, which lasts from three to four 
weeks. It does not come on suddenly like scarlet fever or La Grippe, 
but gradually. It is a week after the first feeling of illness before 
the disease is fully developed. It is caused by disease germs and 
never occurs spontaneously. The germs multiply in the bowels and 
perhaps in the urine of the person suffering from the disease, causing 
fever of a high grade, and marked prostration of the vital forces. 
The germs of typhoid attack the glands of the bowels and cause 
them to inflame and sometimes to ulcerate. It is not contagious 
form person to person, and typhoid patients are admitted to hospi- 



472 THE JfEW MEDICAL WORLD. 

tals without fear of spreading the disease. The period from exposure, 
to the onset of the disease, averages about three weeks. Young 
people are more likely to contract it than mature persons. It is 
more prevalent in the fall than at other seasons, and on this account 
is sometimes called autumn fever. Hot dry seasons, when the water 
supplies run low, increase the number of cases. See bacteria or 
germs in disease, drainage and sewerage, and the other sanitary 
subjects, for origin of typhoid fever. 

SYMPTOMS. 

For several days the patient feels ill with vague symptoms, as 
headache, aching pains in the body, especially the back and limbs, 
with nausea, vomiting and sometimes profuse diarrhoea. The stools 
are thin, watery, and of a light ochre color. The pulse is quick, the 
skin hot and dry, the tongue coated, and sooner or later marked 
tenderness from pressure upon the abdomen, especially upon the right 
side is observed. These symptoms continue to increase, until the 
j>atient gives up and takes his bed. The patient is restless and wake- 
ful, grows weaker constantly, and in severe cases may appear dull 
and slightly deaf. 

The diarrhoea increases in severity, the abdomen seems full and 
bloated. Gurgling sounds are heard in the bowels, and bleeding 
from the nose is common during the first week. By the close of the 
first week the temperature may reach a hundred and two, or a hun- 
dred and four degrees. The fever thermometer is an excellent guide 
to the severity of the attack. See temperature in disease. The 
urine is scanty, thick and highly colored. The eye is bright, the 
temperature is high, the skin dry and the cheeks red and burning. 

In most cases a rose-colored rash appears about the t\\ elfth day 
over the abdomen and chest. These spots disappear under pressure 
from the hand. 

In severe cases there is an intensity of the symptoms, the tongue 
gets brown and dry, and perhaps so fissured as to bleed; the 
pulse is rapid and feeble from exhaustion. The temperature is more 
elevated and the diarrhoea becomes persistent. The nervous system 
manifests symptoms of marked disturbance. There may be mutter- 
ings or acute delirium. In these severe cases where the nervous 
symptoms are aggravated, the limbs tremble and the protrusion of the 
tongue is difficult and trembling. 



THE NEW MEDICAL WORLD. 47o 

Unfavorable cases are liable to terminate in hemorrhage or perfo- 
ration of the bowels. There is liable to be great variation of the 
symptoms in different cases. 

Mild cases occur in which the patient feels ill, has headache, 
but keeps abont. These are known as walking cases of typhoid 
The most common symptom in nearly all cases is persistent 
diarrhoea. 

The history of the temperature ordinarily is as follows : 

It rises gradually for about seven days, remains nearly stationary 
for ten or twelve days more, when the fever declines and the tem- 
perature falls. There is a marked difference between the morning 
and evening temperature. 

This disease is remarkably liable to complications, owing to which 
it may last from forty to sixty days. When it lasts over four weeks 
complications of some kind exist. Pneumonia is sometimes an 
unpleasant complication. There may be a relapse from injudicious 
food or exercise, taken before recovery. Hemorrhage of the bowels 
is sometimes a troublesome complication. Great care is required in 
the nursing of typhoid patients up to the time of complete recovery. 



TREATMENT. 

It ought to be known that typhoid fever runs a distinct course 
and cannot be broken up. A fever that yields quickly and readily to 
treatment is not typhoid. Caution is necessary for the patient not 
to use cathartics, as the mildest laxative acts with great energy, 
owing to the disturbed condition of the bowels. The patient should 
stay in bed, for to attempt to drag around as long as possible is not 
without danger. Some patients appear to have a dread of taking 
the bed, and think if they do so they are more likely to be seriously 
ill or to die. This is wholly a false notion. 

If the bowels move more than three or four times a day they 
should be checked by a pill containing one grain each of opium and 
camphor, repeated as needed. 

The diet should be liquid, and consist of milk, gruel or beef tea. 
Milk at the present time is considered the most appropriate article of 
food for fever patients. It may be combined with bread coffee, or 
lime water, when too hearty. 



474 THE NEW MEDICAL WORLD. 

In ordinary cases very little medication is necessary, good nursing 
being more essential than medicine. When the temperature is high 
and the skin dry, the following prescription is appropriate : 

5 Quinine two scruples 

Phenacetine two scruples 

Salol one scruple 

Mix. Make into twenty powders or capsules. 

Dose one every four hours. When there is troublesome nausea, 
six drops of carbolic acid in half a tumbler of water given in tea- 
spoonful doses every hour, usually affords relief. 

The patient must be restrained from going about too soon before 
recovery. It is wise to intrust the responsibility of a fever patient 
to some one, who is competent to watch developments and safely 
guide the patient past the signals of danger. 

In order to prevent the spread of typhoid fever, it is necessary to 
know something of the source of infection. The stools from a sick 
person, without proper disinfection, should never be thrown out upon 
the soil, a compost heap, or near some stream of water. This disease 
could be banished as effectually as small pox by making a little effort. 
The infectious principle usually enters the system in the drinking 
water. This may be bright, sparkling, tasteless and free from odor, 
and yet contain disease germs in countless numbers. The germs 
leach through the soil and reach the water supply. They maintain 
their vitality for a long time. The stools of a tyhoid patient ought 
to be thoroughly disinfected, by which means, the danger will be 
averted. 

VI.— TYPHUS FEVER. 

This is a contagious fever of severe type, occurring rarely in this 
country. Up to the present century typhus fever was not distin- 
guished from typhoid, both being regarded as the same and due to the 
same cause. In 1846 William Jenner made an investigation and arrived 
at the conclusion that they are two distinct and different diseases. 
The Same view is held by all physicians at the present time. It has 
been known in the past by several names, as spotted, ship, famine, 
camp and jail fever. Severe epidemics of typhus fever have raged 
in the old world, where people have been crowded together and 
suffered for lack of food and the want of cleanliness. In 1846 it 



THE NEW MEDICAL WORLD. 47."> 

prevailed in Ireland, and was known as famine fever. This disease 
destroyed more soldiers in the army of Napoleon than the sword. 
It caused a frightful loss of life in the French and Russian armies 
in the Crimea. It breaks out among those who suffer from exposure 
and want, and in the poor quarters of the great cities where filth 
and misery abound. 

The incubation of this disease requires about twelve days and it 
lasts from two to three weeks. Its onset is more sudden than that of 
typhoid. 

SYMPTOMS. 

The early symptoms are loss of appetite, headache, restlessness 
and chills. The symptoms increase rapidly, the patient soon takes 
his bed, has a peculiar expression, seems weary and dull, lies on the 
back, and is indifferent to Ms surroundings. The pulse is rapid, the 
skin dusky, the eyes dull and leaden, there is languor, moaning, 
and marked prostration. The tongue becomes brown, or even black, 
cracked and fissured. The temperature rises rapidly, reaching one 
hundred and three, four or more degrees. There is great thirst. The 
heart is weak ; trembling and prostration are noticed. The body is 
covered with fine pink spots, which become brown, and have given 
to it the name of spotted fever. The body emits a very peculiar and 
unpleasant odor. The odor of the breath is offensive ; the hearing 
is dull. The nervous system is profoundly impressed. In severe 
cases the patient cannot be aroused, and soon dies from exhaustion. 
In favorable cases the tongue moistens, the fever declines, sweating 
is noticed and the patient recovers rapidly. 

TREATMENT. 

This disease is feared by the nurse and physician, owing to its con- 
tagiousness. It cannot be shortened by treatment or broken up. 
The treatment consists in combating the severity of the symptoms. 
Appropriate nourishment is essential. After a time the patient cares 
for nothing but cold water. Then nourishment must be given like 
medicine, in small and repeated amounts, such as beef tea, broth, 
milk, custard, barley water, lemonade, carbolic acid water and stimu- 
lants. There is no specific line of treatment for this disease. It 
requires skill and treatment on general principles. Do not visit a 
person suffering from typhus fever, unless it is a necessity, and you 



476 THE NEW MEDICAL WORLD. 

are willing to contract the disease. The germs of contagion may be 
transmitted a short distance through the air. They are destroyed by 
the fumes of burning sulphur. Without a knowledge of sanitary 
science, a single case of typhus fever brought into a great city like 
New York, would be the beginning of a disease conflagration, which 
might sweep over the whole country. 

VII.— YELLOW FEVER. 

Formerly the port of Havana was never without yellow fever, and 
nearly every outbreak of this terrible disease has been traced from 
this starting point. It is entirely unlike typhoid, running its course 
in four days. It does not resemble malarial fever, which runs an in- 
definite course. It is a fever of hot countries, caused by disease 
germs. Certain conditions are essential to its development. Cold 
prevents it and checks its progress. It requires heat and moisture to 
assist in its propagation. It is rarely contracted the second time. 
The colored races are less susceptible to it than the whites, and with 
them it is less likely to prove fatal. 

SYMPTOMS. 

The attack comes on suddenly, three or four days after exposure, 
ushered in by a chill, pain in the back, nausea, vomiting and great 
thirst. After the chill the temperature rises to about one hundred 
and three degrees. The skin becomes dry, the face flushed, eyes 
congested, and pain is experienced in the limbs. The tongue is 
heavily coated, except about the edges. The fever rages for about 
three days, when a decline in the temperature takes place, and the 
patient feels so much relieved as to express a desire to have some- 
thing to eat. 

The mortality in this disease is great, but when the patient lives 
beyond the third or fourth day, the chances of recovery are improved. 
In severe cases the skin and whites of the eyes are yellow, and the 
vomited matter looks like coffee grounds, owing to hemorrhage from 
the mucous lining of the stomach. 

TREATMENT. 

The treatment needs only to be briefly outlined. It consists in 
combating the severity of the symptoms. The feet may be soaked in 
hot mustard water, a mustard poultice applied over the stomach, and 



THE NEW MEDICAL WOULD. 4(1 

sweating induced, in order to favor the elimination of the poison 
from the system. Mild cathartics and diuretics may be given with 
the same object in view. Soothing lotions may be applied to the 
head, ice allowed to allay thirst, and lime water and milk as the most 
suitable nourishment. 

Nearly a fourth of those attacked by yellow fever die ; hence, an 
outbreak is dreaded by any community. The germs of yellow fever 
attach themselves to woolen clothing, leather, sawdust, rotting wood, 
straw and the filth of dirty streets. The progress and spread of this 
disease resembles grease upon a piece of paper. Beginning in the 
filthy quarter of the city it extends in every direction, the infected 
circle becoming larger and wider each da} 7 . A tight board fence or 
brick wall arrests its progress. The danger of transporting yellow 
fever is very great, as will be seen from the following. 

A young woman requested to have sent to her, a lock of her dead 
father's hair. It was placed in an envelope and folded in, and sent 
as requested. After a few weeks she examined it and showed it to 
another young lady, both of whom contracted the disease and died 
within six days. 

VIII.— PUERPERAL OR CHILD BED FEVER. 

Puerperal fever is an acute inflammatory disease, following child 
birth. It is due to the absorption of septic material, or the entrance 
of bacteria into the blood ; hence, it is similar in its origin to surgical 
fever, and in its results, resembles blood poisoning. 

The investigations of recent years have thrown much light upon 
the origin and nature of this disease. Formerly, it was very preva- 
lent and fatal in the hospitals, before the importance of antiseptic 
treatment was understood. It was once the dread of the prospective 
mother and her medical attendant, but antiseptic measures have 
relegated this disease to oblivion, and at the present time its occur- 
rence should be regarded in the majority of cases, as positive proof of 
incompetence on the part of the medical attendant. It can nearly 
always be prevented, and w r hen it occurs ; generally, some one has 
blundered in the simple performance of duty. 

SYMPTOMS. 

About three days after labor a chill occurs, ushering in a fever of 
high grade, accompanied by headache, restlessness and inability to 



478 THE NEW MEDICAL WORLD. 

sleep. There is usually some pain and swelling of the lower portion 
of the abdomen and sensitiveness upon pressure. The tongue is 
coated. There is nausea and vomiting, loss of appetite, and usually 
constipation, but sometimes looseness of the bowels. The secretion 
of milk is usually arrested and other secretions diminished. 

TREATMENT. 

Puerperal fever ought in every instance to be prevented, but when 
the septic germs which cause it have once entered the circulation, 
they are largely beyond reach, and the disease must be treated as 
the symptoms demand. 

A measure so simple as the vaginal injection of a carbolic acid 
solution each day will prevent the development of septic poison. 
The directions are as follows : Mix half a dram of carbolic acid 
thoroughly with a pint of hot water. This solution is strong 
enough to prevent septic trouble. For cleansing purposes a solution 
of half the strength is sufficient. Its use should be continued for at 
least a week after confinement or until all discharges have ceased. 

When the disease cannot be prevented, rest should be secured by a 
combination of morphia and chloral. The temperature should be 
reduced by the use of quinine and acetanilid. The patient's strength 
should be maintained by milk, animal broth and stimulants if needed. 
A flaxseed poultice or a turpentine stupe may be applied over the 
abdomen. Other measures should be made use of as needed. 



CHAPTER XXIX, 
NERVOUS DISEASES. 



I. — Epilepsy. II. — Hysteria. III. — Catalepsy. IV. — Ecstacy. 
V. — Chorea or St. Vitus Dance. VI. — Convulsions, 
Fits or Spasms. 

I.— EPILEPSY. 

EPILEPSY is a nervous disorder, closely allied to hysteria, and 
frequently associated with it. In attacks of epilepsy the 
patient usually falls and is unconscious, while in hysteria the patient 
is usually more or less conscious. In connection with falling, con- 
vulsions occur. The fit may last only a few minutes, and months 
may elapse before its recurrence. About fifty per cent, of all cases 
can be traced to a hereditary origin. Syphilis is thought to be 
an agent of some prominence in causing epilepsy. Some cases may 
be traced to falls and injuries, either recent or remote. Fright or the 
use of alcoholic liquors, may account for some cases. It has been 
known to follow meningitis, measles and scarlet fever. A dis- 
turbed condition of the sexual organs is generally mentioned among 
the causes. Diseases of the internal ear, and a large variety of other 
conditions, could be mentioned which are supposed to have some 
relation to this affection. 

SYMPTOMS. 

Before a seizure of epilepsy, some premonitory symptoms are 
usually experienced, as dizziness, headache, certain vague and con- 
fused feelings, drowsiness, irritability, a peculiar restlessness, a feel- 
ing of fear, and threatened danger, and a feeling of depression or 
exhilaration. Disorders of vision are common. The epileptic sub- 
ject may see floods of light, balls of fire, or other brilliant displays. 
The attack may be preceded by a sense of suffocation, palpitation, 
roaring in the ears, and other vague disorders. Children sometimes 



480 THE NEW MEDICAL AVORLD. 

manifest a disposition to fright. In mild cases there may be a 
simple change in the expression, a rolling upward of the eyes, a 
sudden cessation of the conversation, while the head may be thrown 
upward for a brief space, the lips momentarily convulse, and con- 
sciousness is briefly lost. The person thus affected may resume 
work, conversation, eating, or whatever he was doing at the time of 
the seizure, as if nothing had happened. In more severe cases 
the victim utters a scream and falls to the ground. Convulsions 
occur with frothing at the mouth, grinding of the teeth, biting of the 
tongue, and similar symptoms. The respiration is labored. The 
face, at first flushed, becomes pale. The attack may last a few 
minutes or half an hour, after which the patient is usually inclined to 
sleep. There is less danger from epilepsy even when of long dura- 
tion, than from falling. Full recovery from genuine epilepsy rarely 
takes place. The most that can be done is to extend the intervals 
between the attacks. 

TREATMENT. 

During an attack, first, place the patient in a position of safety. 
See that respiration is unimpeded and that the patient is supplied 
with fresh air. Then place a few drops of nitrite of amyl upon a. 
handkerchief and apply to the nose. This repeated a few times 
usually brings the patient quickly to consciousness. If the patient 
can be supplied with this remedy and use it during the premonitory 
symptoms, it will ward off an attack. The following prescription is a 
good one for epilepsy : 

1} Bromide of soda one ounce 

Fl. ext. ergot two ounces 

Anise water two ounces 

Mix. Dose teaspoonful three or four times a day in water. 

Medicines should be used to improve the general condition. A 
nutritious diet, good habits and regular methods of life, are im- 
portant. 

A ten-grain dose of chloral is sometimes necessary to produce 
sleep. The use of alcoholic liquors should be abandoned, modera- 
tion and self-government should be maintained. 

II.— HYSTERIA. 

This is an affection which, though difficult to define, is known to* 
be a functional disease of the brain and spinal cord. The methods- 



THE NEW MEDICAL WORLD. 4St 

of manifestation arc numerous and varied. The causes of this affec- 
tion are often vague and obscure. It may occur at any age, but is 
more common between fifteen and thirty. It occurs among the rich 
and poor and in every condition of life. Females are much more 
liable to hysteria than males. The ratio is estimated as fifty to one. 
Among the causes, heredity lias been considered important. Occupa- 
tions which are uncongenial, may so irritate the nervous system, and 
studies at school so overtax and harass a sensitive brain, as to predis- 
pose to hysteria. 

Educators, rarely consider sufficiently the wide difference in the 
intellectual capacity of those entrusted to their care. Some have 
little or no taste for mathematics or are terrified by a problem in 
geometry. Others have no ability to remember dates or abstract 
facts ; yet they must all pursue the same course as those who have a 
liking and faculty for such things. The slow scholar is urged on to 
keep pace with the more active, and those physically weak must be 
prodded, shamed or ridiculed, to make them keep up with the strong. 

With the dreaded examinations always approaching, is it any 
wonder that many suffer from overwork and become the victims of 
nervous disorders ? The brain is a complex organ, and especially 
liable to suffer from modern methods of educational work. Anaemia, 
chlorosis, and disorders of menstruation are some of the causes of 
hysteria in young women. 

The pregnant condition may so disturb the nervous system as to 
develop it. Any irritation in any part of the body, any special 
strain or exhaustion of the nervous system, especially on the part of 
those who are previously disposed, may be the means of causing 
hysteria. 

SYMPTOMS. 

These have no order in their manifestation. They present an 
unusual variety, including thousands of strange actions and proceed- 
ings. Among the common symptoms are the sensation of a ball or 
lump rising up in the throat, and impeding the respiration, crying, 
moaning, laughing, shrieking, spasms and insensibility to pain. 
Sometimes appearances are feigned, in order to excite sympathy. It 
is common for a physician to be awakened at night by some excited 
messenger, who reports that somebody is dying, and he is urged to 
make all possible haste. Upon his arrival he may find a case of 
hysteria without the least suggestion of danger to him. 



482 THE NEW MEDICAL WORLD, 

TREATMENT. 

The ignorance or foolishness of the patient's friends is often the 
most annoying thing encountered by the physician in these nervous 
cases. They are sure that some grave or fatal inflammation or some 
dreadful malady exists, and that the doctor fails utterly to compre- 
hend the situation. 

Hygienic measures are essential. The will power must be strength- 
ened, and moral influences made use of, by parents and educators. 
Children should be taught to control their nervous emotions by the 
will. Morbid fancies, false ideas and notions should be scouted and the 
follies of fashion and society sensibly prohibited. Emotional excite- 
ments as developed by novel reading should be guarded against, 
Food, sleep, exercise and recreation should receive special attention. 
Fatigue, anxiety, overstudy and all depressing and exhausting influ- 
ences should be avoided. In a few cases, harsh measures have proved 
beneficial, but they should be employed, if at all, with great caution 
and good judgment. If the condition of anaemia exists, it ought to 
be remedied by increased nutrition, physical exercise and iron tonics. 

In the convulsions of hysteria, three or four drops of nitrite of 
amyl, inhaled upon the handkerchief, often affords speedy relief, and 
it may be repeated as occasion requires. A pill of assafoetida is a 
remedy of considerable value in hysterical cases, and may be given 
three or four times a day. Massage and electricity may do good. 

The patient should be encouraged to expect a speedy cure, for hope 
and faith are essential in the treatment of these cases. The patient 
should be encouraged to exercise and cultivate the will power. These 
patients are much benefited by relying upon those persons who are 
strong in character, who can influence them to disregard trifles 
and exercise strength and determination. 

Tablets of sodium and gold chloride, in doses of one- twentieth of a 
grain, are beneficial. The bromide of soda may be given in doses of 
from three to thirty grains. The following is often beneficial : 

IJ, Elix. valerianate of ammonia four ounces 

Dose one teaspoonful three or four times a day. 

III.— CATALEPSY. 

This is a rare nervous affection, quite similar to hysteria, but dif- 
fering in some particulars. It is usually a disease of females 



THE NEW MEDICAL WORLD. 483 

between the as;es of fifteen and thirty, and due to nearly the same 
causes as hysteria. 

SYMPTOMS. 

The seizure comes on suddenly, perhaps with some premonitory 
symptoms as hiccough, the victim becomes rigid and as immovable as 
if petrified. The temperature, respiration and pulse are diminished. 
The patient looks pallid and composed. If changed from one posi- 
tion to another she remains in the new position, no matter how un- 
comfortable, just as if moulded there. This is the most character- 
istic symptom. In some cases the patient is unable to move or 
speak, but is conscious of everything that is going on about her. 
There may be no sensibility to pain. This condition may continue 
for a few minutes, several hours or days. When returning to the 
normal condition, the patient arouses, yawns and appears as if waking 
from a long sleep. This condition is sometimes feigned. 

TREATMENT. 

The treatment is similar to that of hysteria. When the disease is 
continued for several days, artificial or forced feeding becomes neces- 
sary. Antispasmodics, as valerian, camphor and assafoetida render 
good service. The patient usually requires medicine to improve the 
nervous system, as the compound syrup of the hypophosphites, or 
the following. 

]J Tinct. chloride of iron half an ounce 

Dil. phosphoric acid half an ounce 

Syr. of orange peel two ounces 

Water two ounces 

Mix. Dose teaspoonful three times a day after meals. 

IV.—ECSTACY. 

This is a state of exalted feeling which indicates derangement of 
the nervous system and is usually due to some excitement long con- 
tinued. It is usually caused by a high pitch of religious excitement, 
and may be regarded as a sort of temporary religious insanity. The 
patient is in a peculiar state, and gives way to visions and fancies of 
the mind. This condition has been epidemic in some places. During 
the seizure the expression is radiant, and the patient appears to behold 



484 THE NEW MEDICAL WORLD. 

and enjoy beauties and glories not permitted to ordinary mortals. 
The fancies which take place in this visionary state are afterwards 
remembered and recounted. 

TREATMENT. 

This consists in those moral measures which influence the mind. 
Such persons are benefited by contact with those who possess a 
strong will power, and are able to control and influence minds of 
less strength. When medical treatment is necessary, benefit will be 
derived from the remedies recommended in hysteria. The elix. of 
the phosphate of iron and strychnia is appropriate for such cases, in 
teaspoonful dose three times a day. 



V.— CHOREA OR ST. VITUS DANCE. 

Chorea is a spasmodic affection of the nervous system, manifesting 
itself in the irregular jerking of certain muscles or groups of muscles. 
These movements are involuntary, but usually cease during sleep. 
The children of parents, who suffer from derangement of the nervous 
system, show a strong tendency to nervous diseases. Heredity, 
therefore, occupies a prominent place in causing chorea. A large 
share of the cases occur between six and fifteen years of age. 
Whatever tends to disturb the nervous system may appear to cause 
chorea, as overstudy in school, anxiety in regard to examinations, 
or other matters. These, even if they do not originate the trouble, 
seem frequently to aggravate it. A close relationship has been 
noticed between rheumatic affections and the development of chorea. 
Malaria should not be overlooked as a possible cause, and others 
worthy of mention are fright, blows, falls and various mental excite- 
ments. Some of the most unfortunate cases of chorea have occurred 
during pregnancy. 

SYMPTOMS. 

Some decline in the general health, and considerable disturbance 
of the nervous system is usually noticed previous to the onset of this 
disease. The appetite fails somewhat. The patient is restless, irri- 
table and excitable. Slight irregular movements are noticed, the 



THE NEW MEDICAL WOULD. 485 

speech is affected, and there are contortions of the face, which sug- 
gest an idiotic appearance. The action of the heart may be dis- 
turbed. The intellect may appear to be weakened and the memory 
impaired. These symptoms are rarety mistaken for any other dis- 
ease. Chorea is not often fatal, except in cases of unusual severity. 
After apparent recovery a relapse may take place. 

TREATMENT. 

Children suffering from this affection should be removed from 
school, have wholesome food, abundance of fresh air, and be pre- 
vented from playing games of an exciting nature. Baths and friction 
are beneficial. Change of air and residence may be required. The 
patient must be kept free from all annoyance, irritation and excite- 
ment. The peculiar movements ought not to be noticed, for remarks 
about them and scolding are injurious. Fowler's solution is a very 
reliable and efficient remedy, and may be given in the following 
manner: 

Give a child six years old three drops in water after each meal, 
and add to the dose one drop a day until eight or ten are taken. If 
vomiting occurs, or puffiness is noticed about the eyes, stop the medi- 
cine for one or two days. Then begin again with three drops, and 
increase daily as before, until eight or ten drops are borne, or until 
all the symptoms entirely subside. At first no improvement should 
be expected, and the patient may seem worse, but in a week or so 
improvement begins and progresses rapidly. In obstinate cases the 
subcutaneous injection of the foregoing remedy has proved even 
more successful. Jf a remedy is required to produce sleep, the follow- 
ing may be used : 

]J Chloral hydrate one-half dram 

Bromide of soda one dram 

Syr. simple one ounce 

Anise water one ounce 

Mix. Dose a teaspoonful before going to bed to a child six years 
old to secure sleep. To a child twelve or fifteen years old, double 
the amount may be given. In some cases iron is a valuable remedy. 
A one grain pill of the iodide of iron is suitable, or troches of the 
snbcarbonate may be more convenient to administer to children. 
One three times a day is a suitable dose. 



486 THE NEW MEDICAL WORLD. 

The following is a good preparation : 

R Tinct. of iron (muriate | two drams 

Dil. phosphoric acid three drams 

Syr. simple one ounce 

Cinnamon water one ounce 

Mix. Dose one teaspoonful three times a day after meais. 

Strychnia is a valuable tonic. It may be given in tablets, containing 
one y^ of a o;rain two or three times a day. Scutellaria and black 
cohosh are vegetable remedies which have been used in this disease 
with more or less success. The adult dose of Scutellaria is one dram, 
and of the fluid extract of black cohosh one-half that amount. 

YL—COXYULSIOXS, FITS OR SPASMS. 

Convulsions are common, and often alarming, with children whose 
nervous system is excitable. Prior to the fifth year children are sub- 
ject to convulsions from the ordeal of teething. Many acute diseases, 
as diphtheria and scarlet fever, may have their onset in a convulsion. 

Thev are more likely to occur in those of an excitable tempera- 
ment and may be caused by anything which irritates or impresses the 
nervous svstem. The causes, which produce convulsions in children, 
would frequently have no perceptible effect upon a healthy adult. 
Amung these causes may be enumerated fright, indigestible food, 
worms, constipation, and others of a similar nature. Teething is 
especially irritating to the nervous system, and is an ordeal of 
no little moment in the life of a child. See teething. 

Desperate cases of convulsions may occur from eating unripe 
fruits or vegetables not thoroughly cooked. These cases sometimes 
prove fatal from inability to unload the alimentary canal promptly 
and completely. The occurrence of convulsions in the outset of any 
acute disease is not so unfavorable as their occurrence in the last stages. 

SYMPTOMS. 

The symptoms, although well known, may be briefly stated. 
They are restlessness, fretfulness, gritting of the teeth, trembling of 
the muscles, twitching about the mouth, rigid limbs, eyes rolled 
back in the head, hurried and labored breathing, muscular rigidity 
with jerking movements, and others of like character. A spasm may 
be of any grade of severity, from mild to violent. It may be of 



THE NEW IriLEDK AL WORLD. 4 V 7 

brief duration or last for hours. One convulsion may subside and be 
immediately followed by another. Death sometimes occurs without 
return to consciousness. 

TREATMENT. 

Preventive treatment is especially important with respect to chil- 
dren. Their diet demands healthy and nutritious food with light sup- 
pers, consisting of food easily digested. 

Great caution is necessary to prevent nervous children from fright. 
Nurses and others should not be permitted to rehearse exciting 
stories about ghosts or make untruthful representations respecting the 
dark, or anything whatever which is calculated to shock the delicate 
nervous organism of a child. 

In an actual case of convulsions it is necessary, for intelligent 
treatment, to ascertain the cause, and this may prove a puzzle. 
When the child is teething with the gums inflamed and swollen, 
lancing them may be attended by the most happy results. 

It* indigestible food has been eaten the stomach may be safely 
unloaded by giving' the syrup of ipecac, in teaspoonful doses. A 
rectal injection consisting of warm water, castile soap and castor oil, 
will assist in unloading the lower portion of the alimentary canal. 
Cold compresses of vinegar and water may be applied to the head if 
indicated. 

In the beginning of a convulsion it is appropriate to place the 
child quickly in a warm bath, containing a little mustard just enough 
to stimulate the cutaneous nerves. Rub the surface of the body 
briskly and thoroughly. After the bath apply friction by means of 
rubbing with a towel until the skin is dry, then roll up the child in a 
flannel blanket. Two or three drops of nitrite of amyl inhaled from 
a handkerchief will prove to be a timely and efticient remedy in all 
but the most desperate cases. The following prescription secures 
rest and prevents the return of the convulsion : 

3 Chloral sixteen grains 

Bromide of soda half a dram 

Syr. orange peel one ounce 

Wintergreen water one ounce 

Mix. Dose one teaspoonful to a child one year old, and repeat 
every hour as needed. 

The inhalation of ether and chloroform is sometimes cautiously 
used, but cannot be recommended as suitable for private practice. 



CHAPTER XXX. 
GENERAL OR UNCLASSIFIED DISEASES. 



I. — Rickets or Rachitis. II. — Erysipelas. III. — Rheumatism. 
IV. — Gout. V. — Obesity. VI. — Small Pox or Variola. 
VII. — Varioloid. VIII. — The Prevention of Small Pox 
or Vaccination, 

I.— RICKETS OR RACHITIS. 

RICKETS is a disease of childhood in which the nutrition is so 
disordered that the bones are affected by irregular growth and 
deformities. This disease is very common among the over-populated 
and large cities of Europe, especially among the poverty-stricken 
laboring classes, whose food is deficient in nutrition, and whose 
habitations are unheal thful. In this country it is comparatively 
unfrequent, but it sometimes occurs among the well-to-do classes. 

CAUSES. 

The causes which contribute to the development of rickets are 
commonly regarded as lack of nutrition from poverty or dark and 
damp habitations. Children resulting from the marriage of relatives 
and from those who are physically incompatible, are thought to be 
more liable to this disease. 

A mother's health may have much to do with the development of 
her offspring. If she is feeble and lacking in vigor, it is hardly to be 
expected that she can impart health and vigor to her children. 
Hence, whatever tends to enfeeble and deteriorate the original stock 
may be a factor in the development of this unfortunate condition. 

SYMPTOMS. 

These should be detected early, since deformities once established 
are prone to continue through life. 



THE NEW MEDICAL WORLD. 4 s !' 

The first symptoms are usually associated with the digestion, 

as poor appetite and wasting. The child does not thrive, and a lack 
of nourishment is detected. The stools are clay-colored, and the 
formation of bile is thereby shown to be scanty. The pulse is quick 
and the child is peevish and fretful. There appears to be tenderness 
over the body and pain in the joints and lower limbs. The child has 
a peculiarly wasted and aged appearance, a wizen and pinched look, 
and the limbs seem unable to support the weight of the body. The 
fontanelle, or soft spot in the head, is large and continues open 
longer than is natural. When the child attempts to walk the head 
sinks between the shoulders, the face inclines upward and the head 
appears to be drawn backward toward the spine. 

The head appears to be too large for the body to support and 
carry. The abdomen is full and swollen. The bones are soft and 
deformities of the chest and spine begin to be noticed more and 
more. When the disease begins early, the deformities are more 
extensive, the bones are more yielding and hence more marked curva- 
ture in the spine takes place. The tendency of the disease is chronic 
in character. Later in life the bones become harder, but the deformi- 
ties continue. 



TREATMEXT. 

The most satisfactory treatment is preventive. The faults of diet 
should be corrected. Disorders of digestion should be remedied. 
If the child nurses, the mother's milk should be looked after, or if 
bottle fed, attention given to the quality of the milk used. Hygienic 
measures should be earnestly considered. Air. sunshine and proper 
clothing should come to the rescue of the child living in dampness 
and tilth. 

The sea air is beneficial. It aids the appetite and digestion. Rock 
salt added to the child's bath is beneficial. Foods rich in phosphates 
as oatmeal are essential. Amono- the remedies which aid in arresting 
this disease the best are phosphorus, iron and cod liver oil. The 
form of iron best adapted to this disease is the iodide. It may be 
given in pills or the syrup. The latter injures the teeth, but is not 
so objectionable prior to the appearance of the permanent set. A one 
grain pill or from ten to twenty drops of the syrup is a suitable dose 
for a child three times a day. Cod liver oil may l>e given in half 



490 THE NEW MEDICAL WORLD. 

teaspoonful doses or more twice a day. Phosphorus may be given 
as follows : 

1^ Phosphorus one-fourth a grain 

Cod liver oil four ounces 

Mix. Dose a teaspoonful twice a day after meals. 

Massage should be practiced for a few minutes every day with 
the hand covered with olive oil. 

When constipation exists, a drop of the tincture of nux vomica 
given in water two or three times daily will afford relief. 

Supports and surgical procedures have their advantages in ap- 
propriate cases. 

The plaster of Paris jacket when suitably used affords marked 
comfort and improvement. Slight deformities can often be corrected 
by surgical genius. 

II.— ERYSIPELAS. 

This is an acute febrile affection, characterized by a deep, red- 
spreading eruption upon the skin, which is sensitive, painful, and 
accompanied by a peculiar tingling and burning sensation. 

The disease may occur on any part of the body, but is more usual 
about the face. In hospital practice, it is prone to attack wounds 
and causes much concern, for it is liable to spread from patient to 
patient, and its work is of a destructive character. It has been 
maintained, with good reason, that erj^sipelas is closely related 
to puerperal fever. It is due to a specific germ poison. The 
lymphatic vessels of the skin are inflamed by the growth of the 
germ, which causes a spreading eruption upon the surface. It is 
somewhat contagious, but not so much so, as many other contagious 
diseases. 

SYMPTOMS. 

The first stage or period of incubation is short, though its duration 
is not accurately known. The second stage or period of invasion 
lasts from half a day to three days. The stage of inflammation may 
last from six to ten clays, the whole duration of the disease being 
from one to two weeks. The invasion is usually accompanied by a 
chill, followed by fever and the appearance of an eruption upon 
the skin of a local character. This is scarlet, hot and painful, and 



THE NEW MEDICAL WORLD. 491 

tends to spread on all sides. The site of the eruption is tender 
to the touch, and there is a peculiar creeping, burning and tingling 
sensation, which is characteristic. When erysipelas invades the 
tissues about the eyes, they are usually swollen, so that it is impossible 
for the patient to see or to open them. 

When the scalp is invaded, delirium is common. There is usually 
some irritation of the stomach and disturbance of the digestive 
system. 

The bright red and shiny appearance of the skin over the affected 
locality is so well marked, as to attract the eye of the physician and 
enable him to diagnose the trouble at sight. The sensitiveness, heat 
and burning of the skin, combined with its glossy appearance, render 
the diagnosis certain. 

The disease tends to spread from the first center of infection for a 

few days in either a regular or irregular manner, after which the 

advance ceases and the inflamed surface quickly loses its scarlet 

color and appears darker. If the disease has been severe or has 

invaded the scalp, t^ie hair is inclined to fall off more or less after 

recoverv. 

TREATMENT. 

The application of carbolized vaseline to the surface affords great 
relief. It allays the tingling and burning sensation, and soothes the 
inflamed skin. Twenty grains of carbolic acid, mixed with one ounce 
of vaseline is the right proportion. Apply two or three times a day, 
avoiding the eyes. This keeps the air from the skin and checks the 
spread of the disease. The tincture of iodine, painted entirely around 
the eruption in a band one-half inch wide, seems also to check the 
spread of the disease. 

Two grains of .concentrated pepsin with every attempt to take food 
aids its digestion and assists in maintaining the strength. Tincture 
of the chloride of iron, in from ten to twenty drop doses taken in 
water, has been a standard remedy. Injury to the teeth should be 
guarded against, by taking the medicine through a glass tube, or rins- 
ing the mouth afterwards with soda water. Quinine is a valuable 
remedy. Two or three grains should be given in a pill three times a 
day. The diet should consist of animal broths, eggs and milk. 

III.— RHEUMATISM. 

There are several varieties of this affection, as for instance, mus- 
cular, articular, acute, inflammatory and chronic. Then too, the 



492 THE NEW MEDICAL WORLD. 

prominent cause is often made use of to designate the character of 
the affection, and hence we hear of malarial, gonorrhoeal and syphilitic 
rheumatism. 

It is unnecessary to discuss each of these varieties separately. 
Technical differences and close distinctions are only of interest to the 
medical profession. Since this work is designed for the general 
reader, distinctions unless important are confusing and out of place. 

Rheumatism, as known by the household, is a frequent and distres- 
sing disease. Its course is uncertain, and recovery may be tedious 
and delayed. Repeated attacks may occur to render the time of 
recovery indefinite. 

Certain families inherit a tendency to the development of rheuma- 
tism, and generation after generation suffer from it. The cause of 
this disease is somewhat uncertain, as is seen from the differences of 
opinion which are held concerning it. The prevailing opinion, how- 
ever, is that a residence in moist regions, in cold, damp dwellings, 
favors its development. Often an attack seems to be induced by 
some slight exposure, as taking cold. Whatever reduces the vitality 
may favor an attack, as fatigue, prolonged lactation, loss of blood, 
local injuries or any bodily exhaustion. The most prominent factors 
are diminished activity of the functions of the liver, skin and kidneys. 
It has been maintained that an excess of lactic acid is always found 
in the blood during an attack of rheumatism and hence must be the 
cause. Rheumatism attacks all ages and conditions. The } 7 oung and 
the old, the rich and the poor, those scantily and especially those 
luxuriously fed. Acute attacks are more common in early life. 

Muscular rheumatism is probably caused by exposure. It yields to 
applications of heat and anodyne lotions. The acute inflammatory 
form is of a more serious character. It attacks the joints, one after 
another, sometimes until nearly every joint in the body has been 
invaded, and in such cases may last from three to six weeks or 
longer. As improvement takes place in one joint the inflammation, 
pain and swelling attack some other. 

SYMPTOMS. 

These are fever, thirst, high temperature, coated tongue, impaired 
appetite, constipation, scanty and highly colored urine, associated 
with one or more swollen, sensitive and painful joints. Sleep and 
rest are much disturbed by pain, which in some cases is severe and 
exhausting. The breath is feverish and offensive, and the early 



THE NEW MEDICAL WORLD. 4 ( .).'> 

symptoms are followed by perspiration, which has a peculiarly sour 
odor. The pain and inflammation subside in one place only to 
reappear in another. When the inflammation is of a severe type and 
the temperature reaches a high degree, the heart may be involved in 
the inflammation and its valves may be seriously impaired. The re- 
sults of rheumatism upon the heart and its valves are often dis- 
covered by the physician years after an attack. 

TREATMENT. 

The treatment of this disease is sometimes very trying and unsatis- 
factory. For cases of moderate type the following line of treatment 
is effective. Hot applications and soothing lotions are used ex- 
ternally for the relief of pain. 

AY arm poultices with laudanum over the surface may be applied, 
and afford the needed relief. The swollen joint may be enveloped in 
cotton batting, and outside a flannel or piece of oiled silk may be 
placed. This is a helpful measure. It excludes the air and allays 
pain. Cloths wrung out of hot water or hot fomentations are excel- 
lent. The following liniment may be used : 

I£ Camphorated oil three ounces 

Chloroform seven drams 

Oil of mustard one dram 

Mix. Apply as needed to the sensitive joint. 

Recovery is favored by keeping the bowels and kidneys active. 
The cream of tartar lemonade is a useful and cooling drink. The 
granular effervescent bicarbonate of potash is an excellent alkaline 
drink. A dessert spoonful in a half glass of water may be taken 
every two or four hours. The granular effervescent salicylate of 
soda or salicydic acid are good remedies. A teaspoonful or more 
every four hours. Wine of colchicum seed is one of the old but 
efficient remedies. It may be given with the bicarbonate of potash, 
as in the following prescription : 

]J Bicarbonate of potash two drams 

Salicylate of soda . four drams 

Sweet spts. of nitre half an ounce 

Wine of colchicum seed half an ounce 

Syr. of orange peel one and a half ounces 

Water q. s. to make four ounces 
Mix. Dose one teaspoonful in water every four hours. 



494 THE NEW MEDICAL WORLD. 

Salicin is a good remedy. It must be taken in large doses, as 
a heaping teaspoonful for an adult three times a day. When pain is 
severe a ten-grain dose of Dover's powder may be given at night to 
allay it. This remedy given to children must be in property 
reduced doses. 

While the fever lasts, the diet should consist of simple foods, as 
gruel, milk, animal broths, rice, cornstarch, tapioca and similar ap- 
propriate articles. When the disease has produced marked debility, 
tonics as quinine or iron aid recovery. The prescriptions for aimemia 
are suitable for these cases. (See page 182.) 

Those who inherit rheumatic tendencies, or who have suffered from 
previous attacks, should seek to ward them off in the future by 
appropriate living and preventive medicines. 

The functions of the liver and kidneys should receive attention. 
A sallow complexion and constipated bowels should be remedied, and 
care taken to see that the waste products of the system are promptly 
eliminated. 

Those liable to rheumatism should protect themselves with suitable 
clothing from cold, dampness and other climatic changes. Getting 
wet or getting the feet wet and other exposures should be avoided, 
and persons subject to rheumatism will be benefited by wearing flan- 
nel or silk next to the skin the whole of the year. Silk may take 
the place of flannel during hot weather. Rheumatism is a disease 
closely allied to gout. Prevention, if possible, is desirable for when 
once rheumatic trouble has been neglected or has become the habit 
of the system, it has been known to last for months or even years and 
sometimes throughout life. 

IV.— GOUT. 

There is a marked resemblance between gout and rheumatism, as 
both are hereditary in character. Gout is associated more with the 
small joints than rheumatism, and is more chronic in its course. 
There are enlargements of the joints which become permanent, 
especially the toe and finger joints. It is usually attributed to high 
living, indolent habits, excess of animal food, together with the use 
of wines, liquors and lack of exercise. 

The fever is not so well marked as in rheumatism. The attack 
comes on suddenly, often at night, awakening the victim by the 
severity of the pain. The affected joint, perhaps that of the great 



THE NEW MEDICAL 'WORLD. 41*.") 

toe, is tender, hot and somewhat reddened. The pain is very excru- 
ciating and sleep is impossible. The urine is scanty, highly colored, 

and contains a large amount of uric acid and urates. The urate of 
soda is often deposited about the joints. 

TREATMENT. 

Regulation of the diet is the most important part of the treatment. 
The patient is usually more or less troubled with dyspepsia, as shown 
by fermentation of the food or acidity of the stomach, and is unable 
to digest starchy foods properly. The amount of sugar used should 
be restricted to the smallest quantity possible. Potatoes and corn 
meal if used at all should be in moderate quantity. The patient 
ought to abstain from wine, beer and liquors. Abernethy's pet rule 
for gouty patients was "Live on a shilling a day and earn the shilling." 

Sedentary habits are not conducive to the well being of gout sub- 
jects. An increased amount of exercise is recommended. This 
disease is said to be much less prevalent in mild climates, where out- 
door life is the rule/ Bathing in hot water followed by friction to 
stimulate the pores of the skin is serviceable. Pepsin may be used 
to aid the digestion, or pepsin combined with pancreatin. If the 
liver is sluggish, podophyllin in doses of one-tenth of a grain fre- 
quently repeated is excellent to regulate its functions. This remedy 
may be obtained in parvules or tablets, and while the dose is small, 
if persisted in daily, it will do its work satisfactorily. 

Colchicum is a remedy which has stood the test of time, and has 
the reputation of affording relief. Fifteen or twenty drops of the 
wine of colchicum seed three times a day is a proper dose. It is an 
efficient remedy and may be combined with liquid ferro-salicylata. 
It is also a powerful remedy and must be used with caution. See 
prescription below. 

Lithia is a good remedy for gout. The granular effervescent 
lithiated potash, a heaping teaspoonful in half a glass of water three 
times a day is appropriate. The various remedies for rheumatism are 
appropriate for the gout. The chief difference in the two diseases 
being that gout is more chronic, more likely to recur and to continue 
on to the close of life. The following is an excellent prescription for 
chronic cases of gout : 

I£ Liq. Ferro-salicylata three ounces 

Wine of colchicum seed one ounce 



496 THE NEW MEDICAL WORLD. 

Mix. Dose for an adult one teaspoonful in water three times 
a day. If this prescription loosens the bowels unpleasantly the dose 
must be diminished or omitted for a day or two. 

V.— OBESITY. 

This is a subject of considerable interest to a large number of per- 
sons who constantly increase in weight and become more and more 
corpulent, contrary to their wishes and well being. A certain 
amount of fat may be regarded as natural, favorable to good 
appearance and to good health. It gives to the body a condition of 
plumpness, protects the joints and nerves from injury, and prevents 
too rapid radiation of the animal heat. When the accumulation 
is excessive it interferes with the movements of the body and its 
natural functions. It is then to be regarded with apprehension, and 
the means for holding it in check are to be considered. 

In some instances this condition seems to be due to hereditary 
tendency, to inactivity, sedentary occupations, high living, or a diet 
composed of rich and fat producing foods. The means by which it is 
induced furnish us with important suggestions as to the best means 
of preventing it. If no attention is given to this matter the fat 
of the body may increase to an enormous extent. Most medicines 
which diminish the surplus fat are of doubtful utility, since they are 
liable to interfere with the process of digestion or prevent the 
assimilation of food. 

TREATMENT. 

The fluid extract of bladder wrack, a common sea weed, has some 
reputation as a remedy for obesity. Whatever efficiency it possesses 
is probably due to its cathartic properties and to the iodine which it 
contains. The dose of the fluid extract is one or two teaspoon fuls 
three times a day. It is a harmless drug, and must be continued for 
a long time. 

The best plan for reducing surplus fat is to place restrictions upon 
the amount and kind of food taken. A habit should be established 
in reference to the diet and made permanent. The process of re- 
duction should be gradual. Hasty reforms are less likely to be last- 
ing. The temptations of the table should be removed. Pastry, 
fatty foods and rich gravies are to be avoided. Starchy foods, like 
potatoes, peas and rice, are objectionable. Sugar and other sweets 
must be used, if at all, sparingly. The amount of tea and coffee used 



THE NEW MEDICAL \\'<>KLI>. 497 

should be reduced to the minimum. Butter, cheese, cream and similar 
articles are to be given up on general principles. Lean meat, eggs, 
fish and green vegetables, with a limited amount of bread, are 
the standard articles of diet. Plenty of exercise and the Turkish 
bath are beneficial. 

Of late the fluid extract of pokeroot (Phytolacca) is attracting 
considerable attention as a remedy for obesity. It is used also for 
chronic rheumatism. The dose is from one-fourth to one-half of 
a teaspoonful three times a day. A thorough trial of this remedy in 
small doses, together with the other measures suggested, is recom- 
mended. Ten drops taken one-half hour before each meal, and 
again ten drops after each meal, will produce better results than 
larger doses. 

VI.— SMALL FOX OR VARIOLA. 

This is an acute, contagious disease accompanied by a high fever, 
and a peculiar eruption on the skin. Ancient writings prove that 
it occurred very early in the history of the human famihy. At present 
it is much less common than formerly, owing to the discovery of Dr. 
Edward Jenner, and the general protection afforded by vaccination. 

It is the most contagious disease known. It attacks all ages and 
conditions, male and female alike. It is due to a specific germ, which 
acts upon the system as blood poison. You can no more have small 
pox without the introduction into the system of the proper germ, 
than the housewife can have her bread rise and omit the germ of 
fermentation. This disease is more prevalent in cold than in warm 
weather. It is a loathsome, terrible and dreaded scourge which is 
attended by a large mortality. It reaches the unprotected usually 
through the air, entering the system by way of the lungs. The dis- 
ease germ may come from the breath, skin and all parts of the body 
of an infected person. 

It may be transported by means of clothing, paper money, rags and 
various articles of merchandise, as the germs retain their vitality 
for a long period. Vaccination is the only protection which the 
physician, nurse or other persons can have, unless they have previously 
had the disease itself. 

The time between the exposure and the breaking out or incubation 
of this affection is on the average fourteen days. 



498 THE NEW MEDICAL WORLD. 

SYMPTOMS. 

These begin to appear after the stage of incubation or fourteen 
days after exposure. The stage of invasion lasts about two days. 
There is great thirst, chilly sensations, high temperature, bounding 
pulse, loss of appetite with a severe cutting pain in the back and 
head. The poison acting on the nerve centers produces an intense 
headache and an agonizing backache. During the incubation the 
patient enjoys perfect health, but with the period of invasion the 
s3 r mptoms are so conspicuous that the disease, when prevailing, may 
be correctly suspected before the eruption appears. The onset of the 
disease with children is sometimes attended with delirium and con- 
vulsions. After the above symptoms have lasted about two days, the 
characteristic eruption appears in minute points. With the breaking 
out of the eruption, the headache and backache disappear, the tem- 
perature declines and also the pulse. 

The eruptions somewhat resemble measles at first, but rapidly 
increase in number and size. A hard feeling as if shot were imbeded 
in the skin may be detected by the hand. In about three days these 
indurated spots are transformed into vesicles and contain fluid. A 
depression forms in the center of the vesicle and to this depression 
the term umbilicated is applied. This umbilicated depression is 
characteristic of small pox. By the sixth day the pock reaches its 
maturity and is filled with pus. These pustules are in some cases 
very numerous, covering over the entire body. The whole appearance 
is now repulsive. The eyes are swollen and closed, and in severe 
cases the condition is fearful and deplorable. The mouth is sore, 
pustules form on the tongue, inside of the lips and sometimes in the 
throat and elsewhere. The patient's condition is one of extreme 
distress and suffering. After several days the pustules dry up, and 
scabs appear which finally peel off and leave a scar. If the patient 
has been previously vaccinated, the disease runs a milder course, and 
is called varioloid. 

TREATMENT. 

Having been exposed to small pox, vaccination should at once be 
performed. If a person is vaccinated six days after exposure to 
small pox it will modify the disease, but the sooner vaccination is 
performed after exposure the better. 

There is no specific or satisfactory method of treatment fcr small 
pox, beyond meeting the symptoms and relieving the patient as much 



THE XEW MEDICAL WORLD. 499 

as possible from suffering. The itching is well nigh intolerable, and 
yet the patient has to be prevented from scratching off the scabs. 
Chloral may be used, it there are no signs of heart failure, in doses of 
from ten to twenty grains to promote sleep. The diet should consist 
i)i milk, beef broth, oyster-, and similar fools, [ce may be allowed 
to relieve the burning heat from the pustules in the month. Water 
dressings have been successfully used on the face and hands. A 
soothing ointment may be applied to the face, composed of carbolic 
acid, ten grains and vaseline one ounce. Many other remedies have 
been recommended. Cream of tartar lemonade is a cooling drink, 
and helps to keep the kidneys active in this disease. 

The stools of the patient should be disinfected by strong carbolic 
acid, copperas or corrosive sublimate solution. 

After recovery the room should be treated with thorough fumiga- 
tion, as for diphtheria, and the clothing and bedding used by the 
patient destroyed by tire. See disinfection after diphtheria. 

VII.— VARIOLOID. 

This is usually a mild form of small pox, the disease being favorably 
affected or modified by a previous vaccination. The symptoms of 
the disease are similar in every respect to small pox, except that they 
are very much less intense. The eruptive process i- cut short at an 
earlv stage and fails to reach its full development. It seems probable 
that varioloid could be avoided if every one would pay attention to 
revaccination after the lapse of a few years. 

There are many cases in which the primary vaccination works in 
an unsatisfactory manner, and the amount of protection it affords i- 
not sufficient for the whole term of life. Revaccination would fortify 
the system in these cases and prevent the outbreak of varioloid. 

TREATMEXT. 

The treatment of this mild form of small pox is the same as that 
of the genuine disease, and does not need to be repeated. Isolation 
of the patient, care respecting diet, and a few simple remedies 
adapted to the manifestations of the disease will be sufficient to 
carry the patient through it successfully. The same care is required 
to prevent the spread of the disease as in small pox and the same 
measures of disinfection should be carried out after the disease is 
over. 



500 THE NEAV MEDICAL WORLD. 

VIII.— THE PREVENTION OF SMALL POX OR VACCI 

NATION. 

It is now agreed with but little dissension that the best means of 
preventing small pox is vaccination. Before the process of vaccina- 
tion was discovered, it was customary to inoculate with the genuine 
small pox. This process, it was found, modified the disease, rendered 
it comparatively mild, and in the great majority of cases was success- 
ful ; yet it occasionally proved fatal, and great care had to be exercised 
as inoculated persons could communicate the genuine small pox. 
Long ago this method was abandoned, owing to the discovery of 
one, more simple and as effective. 

It was observed that those who accidentally contracted cow pox, 
did not subsequently contract small pox, no matter how much they 
were exposed to the contagion. The credit of making known this 
discovery to the world is due to an English country physician by the 
name of Edward Jenner. By actual experience it is learned that 
out of a great number vaccinated in infancy, a few only ever contract 
small pox, and that they have the disease in a much milder form 
than those who have never been vaccinated. It has been ascertained 
that positive protection requires the repetition of vaccination, more 
especially when it was performed in infancy. 

An outbreak of small pox in any community renders it advisable for 
all persons to be immediately revaccinated as a measure of prudence. 
The trouble is small compared with the benefit conferred, and though 
it is not likely to take, in many cases, with anything like the vigor of 
the first vaccination, it affords a sense of security which is valuable. 

The idea that vaccination is injurious as at present conducted, 
ought not to be entertained for a single moment. The method now 
employed avoids every possibility of introducing syphilis, or any- 
thing harmful, and to oppose vaccination is proof that one has 
become the victim of a silly and needless prejudice. 

Time tends to diminish the degree of protection which vaccination 
affords. On this account it is well to have the operation repeated 
every few years, especially if the original scar becomes indistinct. 

Formerly the matter used for vaccination was the pus taken from 
the pustule of a healthy infant, or young person, but as infants may 
be supposed to be healthy who are not, it is admitted that in the old 
way there was a possibility of introducing some impurities into 
the system of the person thus vaccinated. 



THE MEW MEDICAL WORLD. 501 

This objection does not hold under the present method of pro- 
cedure, which is sufficiently perfect to satisfy the most fastidious. 
The present method is as follows: A clean ivory point is dipped 
into the pustule of a healthy calf previously vaccinated. When 
withdrawn it is covered with matter which is allowed to dry upon it- 
This dried matter, like a dry yeast cake, is full of germs, which will 
do effective work when placed in favoring conditions. This dried 
point is securely wrapped, kept in a cool place and used within two 
or three weeks. 

Directions for the operation are as follows : Dip the ivory 
point into pure cold water to moisten the virus. The point thus 
moistened must not be placed in contact with any contaminating 
substance. From the arm or leg scrape off a portion of the scarf 
skin, about the size of a child's little linger nail. This should be 
done with a sharp, clean knife. It is unnecessary to draw blood, but 
only moisture or serum, and little red points are to be observed 
on the denuded surface. Then take the moist point by the dry end 
and rub the moistenejl end over the prepared spot repeatedly until 
you have wiped off all the virus upon it. Let it dry a few minutes 
and the operation is complete. It does not involve pain if properly 
done, but only a slight sensation, hardly noticeable. 

Children ought not to travel on the cars or in public conveyances 
before vaccination, and this simple and certain protection should be 
afforded previous to attending school. 

A child should be vaccinated at about three months of age. This 
will obviate the necessity of vaccination during dentition, when the 
child has enough to contend with. Vaccination should not take 
place in houses where diphtheria or erysipelas exists, as there 
would be some danger of inoculating these diseases. With the ex- 
ercise of proper care vaccination may be considered to be without 
risk. 

It often causes some temporaiy eruption, fever and swelling of the 
vaccinated arm, but these are of short duration and of trivial conse- 
quence. 



CHAPTER XXXI. 
VARIOUS INFLAMMATORY AFFECTIONS. 



I. — Inflammations. II. — Abscesses. III. — Felon or Whit- 
low. IV. — Onychia or Suppuration of the Matrix. 
V. — Ingrowing Nail or Onyxis. VI. — Chilblains. 
VII. — Boils and Furuncles. VIII. — Carbuncles. IX. — 
Malignant Pustule or Anthrax. X. — Glanders. 
XI. — Hydrophobia or Rabies. XII. — Tumors. 

I.— INFLAMMATIONS. 

WASTE products, or poisonous bacteria, multiplying in the 
system depress its vitality, weaken the circulation, and may 
give rise to inflammation. 

Malarial and other poisons enter the system in the act of respira- 
tion. Bacteria may reach the system by means of the drinking water 
or food products. Other septic material may find an entrance into 
the system through an abrasion upon the skin or some wound. 
Nature is not only obliged to carry on a constant warfare with 
poisonous substances elaborated in the tissues, but also those which 
may exist in the air and water supplies. The more vigor and 
vitality a person possesses the better nature is able to perform this 
constant and important work. When the vitality is weak or the 
amount of poison to be eliminated is excessive, nature may be 
overwhelmed and unable to perform successfully the task which she 
attempts. Such failure, may result in prostration, sickness, and 
perhaps death. Inflammation is a common and frequent method of 
proof that nature has been unable to successfully eliminate various 
poisons from the system. 

The symptoms of inflammation are redness, heat*, pain and 
swelling. The redness is due to congestion, the result of obstructed 
circulation of the blood. This is the first stage in many acute 
diseases, as pneumonia, meningitis, etc. 

Heat is an important factor. Its degree determines the character 



THE NEW MEDICAL WORLD. 503 

of the inflammation. Most acute sickness shows elevation of the 
temperature. Any decided variation from the normal temperature 
shows that a person is sick, for in health the bodily temperature 

manifests almost no variation. This increase of temperature accounts 
for many of the symptoms to which we have so frequently referred, 
as thirst, loss of appetite, quickened respiration, emaciation and 
arrested or altered secretions. When inflammation goes on to the 
formation of pus the temperature continues to be elevated, and 
this fact often aids in suspecting and locating the trouble. Diseases 
resulting from germs or bacteria cause an elevation in temperature. 
Their multiplication and growth produce fermentation in the blood, 
which, coupled with the efforts of nature to eliminate them, accounts 
for the rising temperature, the thirst, fever and other symptoms. 

The pain of inflammation is due to irritation, swelling and pressure 
ivpon the nerves produced by the inflammatory process. The greater 
the swelling, usually the more intense is the pain, owing to increased 
pressure. Those parts which are most liberally supplied with blood 
and sensitive nerves, are more responsive to the action of inflamma- 
tion and experience hiore pain than other parts less liberally supplied. 
The swelling of inflammation is due to several causes, as the extrav- 
asation of blood, lymph, and serum into the tissues. The white 
blood corpuscles possessing the ability to pass out of the blood 
vessels into the inflamed tissues, may also increase the swelling. 

There are many causes of inflammation, as traumatic, or those due 
to injuries and accidents ; toxic, or those due to the action of poison ; 
infectious, or those due to the action of septic germs ; constitutional, 
or those due to diseases of a hereditary type. Traumatic inflamma- 
tions are produced in a great variety of ways, as cutting, tearing, 
crushing parts of the body, and injuries produced by blows, falls, or 
from machinery, or the application of heat and cold, or contact with 
caustic chemicals, acids and poisons. 

The inflammation of rheumatism and gout are caused by a reten- 
tion in the system of waste materials which nature has been unable 
to properly eliminate, and is toxic in character. 

The inflammation of tubercular consumption is caused by septic- 
disease germs, producing fermentation in the blood and the destruc- 
tion of tissue in the lungs, where they congregate and multiply in 
immense numbers. Many other varieties of inflammation are pro- 
duced by disease germs, as erysipelas, diphtheria, scarlet fever, typhoid 
fever, glanders and a great many others. 



504 THE NEW MEDICAL WORLD. 

The treatment of any inflammation depends largely upon the cause 
which produces it. It is evident to every one that the cut of a sharp 
knife requires very different treatment from the bite of a rabid 
animal. 

II.— ABSCESSES. 

An abscess is a collection of pus or matter in some portion of the 
body. This pus is usually loaded with multitudes of bacteria or 
germs. When an abscess forms rapidly, it is known as an acute 
abscess, but when it is a long time developing, it is a cold or chronic 
abscess. Abscesses are frequent in the debilitated, and are supposed 
to have some relation' to a depraved condition of the blood. They 
are liable to originate in the glands of those who are afflicted with 
scrofula or other constitutional diseases. They sometimes result 
from injuries. 

Nature sometimes attempts to relieve the system of certain poisons 
by establishing an abscess. An acute abscess disturbs the normal 
condition and produces the symptoms of inflammation, as redness, 
heat, pain and swelling. As the abscess progresses, the symptoms 
become more marked, and the pain is of a throbbing type. A chill 
may take place followed by fever and profuse sweating. 

The pus in an abscess tends to work its way in the line of the 
least resistance, either towards the surface of the body, or some of 
the great internal cavities and often doing much damage while seeking 
an outlet. If the pus is prevented from traveling in one direction 
by dense tissues as the periosteum, it burrows its way in another 
direction, often reaching a joint or some remote outlet far away from 
the site of the original abscess. A superficial collection of pus can 
generally be detected by the fingers. 

TREATMENT. 

An abscess may sometimes be left to nature when it will reach the 
surface, rupture, discharge and disappear, but such a result cannot 
always be expected. It is often necessary to stop the destructive 
process of an abscess by opening into it, and giving exit to the pent 
up pus. This operation should be performed with care, as large 
blood vessels might be wounded and other dangers encountered. 
Hot fomentations and warm poultices of flaxseed meal, slippery 
elm, or bread and milk, may soften the swelling and ease the pain, 



THE NEW MEDICAL WORLD. 505 

thus hastening the opening of the abscess and affording at the same 
time no little comfort. They should only be applied when an abscess 
is near the surface and to hasten its rupture. The pus of a deep 
seated abscess is often drawn off by an aspirator, but it is sometimes 
better to make a free opening into the abscess sac so as to thoroughly 
liberate the pus. When an abscess has been opened, it should be 
kept open by the application of a hot poultice for a short time or 
warm water dressings. If the abscess cavity is large, it should be 
thoroughly cleansed each day by a carbolic or other antiseptic wash. 
In debilitated cases tonics are necessary. The contents of an abscess 
is sometimes absorbed. The aspiration of the pleural cavity to 
remove purulent matter from the chest has often resulted favorably. 
Drawing off the pus is the most rational method of treatment in 
empyema, a condition which may follow a severe attack of pleurisy. 
This and other special conditions as quinsy and whitlow are men- 
tioned elsewhere under their appropriate heads. 

III.— FELON OR WHITLOW. 

This is a very painful affection, well known and easily recognized 
by those who have suffered from it. A felon has its origin in an 
abscess which forms between the bone and the thick inelastic mem- 
brane which covers it, called the periosteum. 

Owing to the density of this tissue the pus cannot work its way 
through it easily, and so it often works its way along, burrowing 
underneath this membrane seeking an outlet, doing a great amount 
of damage and causing great pain. Sometimes a portion of the 
bone is destroyed, and sometimes a joint of the finger is stiffened or 
destroyed altogether, when proper treatment is delayed. Fever 
sores are similar in some respects to a bone felon, for they are due in 
the first place to an abscess which causes the death of a portion of 
the bone, and so long as this dead bone remains the abscess will con- 
tinue to discharge pus. Felons are caused usually by some slight 
injury, often unobserved at the time, or perhaps only faintly re- 
membered. The inside of the hand or finger is hit against some 
object, which may cause a deep-seated abscess. In the palm of the 
hand they are often caused by pressure or friction. They may 
result from an axe or hoe handle, a scythe snath, plough handle 
or other implement used by one previously unaccustomed to labor. 
It is probable that heat, pressure and friction, combine to cause these 
inflammations. 



506 THE NEW MEDICAL WORLD. 

The first thing noticed is a callous or blister, beneath which is ex- 
perienced a sense of soreness, which the patient usually attempts to 
treat by pricking with a knife point or needle. Suppuration follows 
the inflammation. It is a painful process, owing to the situation of 
the affection, and also to the fact that the periosteum is unyielding. 

TREATMENT. 

Abortive treatment must be applied early in order to be availing. 
Put the linger or hand into a hot alkaline solution, as hot as can be 
borne. To make the solution, add to water either wood ashes, soft 
soap, baking soda, or a small amount of liquid ammonia or potash. 
The solution must be kept as hot as can be borne by the painful 
finger or hand, which must be held in it a long time, and then paint 
the finger over with the following mixture : 

1^ Nitrate of silver twenty grains 

Spirits of nitrous ether one half ounce 

This will abort a felon if applied soon enough. The tincture 
of iodine, if painted on early, will also abort a felon. 

The following is said to work well : Moisten common salt with 
turpentine and keep it applied, renewing it twice daily. 

The surgeon rarely sees a felon before suppuration is well ad- 
vanced, and then the only treatment is to cut with a sharp knife or 
bistoury down to the bone. This opens through the periosteum and 
allows the pus to escape. If too long delay occurs before the felon is 
opened there is liable to be not only the destruction of bone, but a 
tedious process of healing. After a felon is opened it should be 
dressed with soft poultices for a day or two to relieve pain and favor 
the exit of pus. 

IY._ ONYCHIA OR SUPPURATION OF THE MATRIX. 

Onychia is the suppuration of the root of the nail or matrix. It 
is a disease common to unhealthy children, and usually originates 
from some slight injury. It commences with the symptoms of in- 
flammation, redness, pain and swelling about the root of the nail, 
followed by the development of pus or matter. Sometimes the nail 
loosens and falls out. This disease is sometimes associated with a 
syphilitic taint. 



THE NEW MEDICAL WORLD. 507 

TREATMENT. 

Apply stimulating remedies as the tincture of iodine. When pus 
forms, remove it, and apply cleansing lotions as earbolized water, ten 
grains of the aeid to the ounce of water. This cleanses and improves 
the condition of the sore. After thorough cleansing, apply aristol 
powder or iodoform, dusting it well into the diseased parts. 

Tonics and constitutional treatment are in order to improve the 
general condition. Such well known tonics as the syrup of the 
iodide of iron, ten or twenty drops, three times a day, or iron and 
calisava, or the compound syrup of hypophosphites is beneficial to 
improve the general condition. 

Y.— INGROWING NAIL OR ONYXIS. 

This is sometimes a troublesome and painful affection. It may 
result from pressure of the shoe or boot on the outside of the great 
toe, pressing it so that its inner corner overrides the second toe. 
When long continued, this crowds the soft flesh against the edges of 
the nail, and bends the nail into the flesh, causing irritation and sore- 
ness. Sometimes ulceration takes place as the result of the continued 
irritation, generally on the inside of the great toe, and while the 
cause exists, the ulcer refuses to heal. 

TREATMENT. 

The first indication is to remove the pressure by wearing broad or 
box-toed shoes. Relief is afforded in less severe cases by soaking 
the feet often and removing the callous and dead skin along with any 
fungous portion of the edge of the nail. 

Removing the soft portion of the toe which bulges over the margin 
of the nail has sometimes afforded relief. After such removal the 
wounded surface may be painted over with collodion or treated as 
any slight wound. Caustic potash can be applied to a portion of the 
nail; this will soften it, when it may be pared away with a sharp 
knife. If at any time proud flesh or unhealthy granulations are 
observed, they should be touched with a pencil of nitrate of silver. 

The following recommendation for the treatment of ingrowing toe 
nail has recently appeared and may be tried : Remove all pressure 
by wearing a loose shoe or slipper, for this is imperative. Have a 
pledget of cotton crowded under the nail so as to somewhat elevate 



508 THE NEW MEDICAL WORLD. 

the point which occasions the trouble, then allow a few drops of the 
muriate tincture of iron to fall upon the cotton. The iron deadens 
the sensibility so that the next day the cotton can be worked down 
further under the nail. This course must be continued until the 
point of the nail is lifted away from the flesh, when it can be snipped 
off. The author of this method of treatment assures us that patience, 
cotton, iron and the endurance of a little pain will work a cure in 
every case. 

A sure cure may be obtained by having the whole or a portion of 
the nail removed. This operation will be successful if thoroughly 
done. The root portion of the nail must be drawn out and removed 
at the same time to prevent a recurrence of the trouble. This 
operation effects a certain cure, and is the best when one has 
neither time nor patience to submit to a less rapid method. It may 
be done with the patient under the influence of an anesthetic, and is 
then rapid and painless. 

VI.— CHILBLAINS. 

These are superficial inflammations of the skin of a local charac- 
ter. The common sites of chilblains are the heels, toes, and some- 
times the ears and nose. They are frequent with those whose circu- 
lation is lacking in vigor, and who are especially sensitive to changes 
in the temperature. The cause of chilblains is principally sudden 
changes of temperature, or chilling or slightly frosting the skin. 

They are characterized by excessive tenderness and troublesome 
itching. These symptoms are aggravated by the approach of even- 
ing or the approach of changes in the weather and the application of 
external warmth. It is on this account that they are often trouble- 
some at night and prevent sleep. 

TREATMENT. 

Avoid tight- fitting shoes and wear warm stockings to improve the 
circulation in the feet, and to prevent the chilling of the skin. This 
is preventive treatment, but when blisters have formed the following 
should be applied : 

r} Vaseline two ounces 

Carbolic acid ten to twenty grains 

Ext. of opium one dram 



THE NEW MEDICAL WORLD. 509 

This is to be mixed into an ointment and applied two or three 
times a day. 

If the skin is unbroken the tincture of iodine or camphor liniment 
will afford relief. If the chilblains are painful add one dram of 
laudanum to each ounce of camphor liniment for this disagreeable 
affection or use the following : 

TJl Menthol one dram 

Alcohol one ounce 

Oil of clove ten drops 

Oil of cinnamon ten drops 

Mix and apply as needed. 

When ulceration has taken place cleanse the sores with hot water 
and castile soap, then apply to them the carbolized ointment as 
above, or dress with powdered aristol or iodoform. 

VII.— BOILS AKD FURUNCLES. 

Boils are troublesome local swellings or inflammations, which 
originate in the cellular tissue under the skin. The surround- 
ing tissues are hard and form a circular, elevated lump or mass, the 
center of which becomes the opening point for the discharge of mat- 
ter or pus when the boil gets ripe. This lump of inflamed tissue 
presses upon the nerves and other neighboring tissues, causing 
intense and throbbing pain. The degree of pain depends largely 
upon the locality and amount of the swelling. Boils upon the neck 
are especially painful. 

The pain increases with the pressure, and is most severe just 
before the pus is discharged. When left to nature a rupture finally 
takes place in the center of the swelling, which affords great relief. 
Through this opening the core is discharged. The center of the 
swelling is now depressed, but some redness, elevation and hardness, 
continues for some time about the circumference. This gradually 
subsides and the process of healing by granulation becomes com- 
plete. Boils rarely endanger life, however numerous, but they 
often occasion great inconvenience and a degree of pain out of pro- 
portion to their size and consequence. 

CAUSES. 

These are not well known. They frequently appear to result in 
consequence of some debilitated condition of the system, but this 



510 THE NEW MEDICAL WORLD. 

cannot be stated as a rule, for the}^ often appear in persons in whom, 
no such condition of debility exists. Sometimes they follow some 
slight injury, but this is the exception rather than the rule. They 
are especially common with laborers who work in tanyards and 
handle the skins of animals ; and they are also common with those 
who breathe the fetid odors of the dissecting room or other fetid 
animal exhalations. Some have maintained that they result from 
eating diseased meat, and from various other causes, but in many 
other instances they appear without any assignable cause. As the 
skin and cellular tissues hold in their meshes many absorbent vessels 
and glands, it would seem as though boils are the result of some 
septic material or poison, introduced into the system from without, 
by coming into neighboring contact with these sensitive absorbent 
glands or vessels in the skin, or in some cases by being inhaled and 
coming into sufficient contact Avith the absorbent system in the 
lungs. 

TREATMENT. 

You can only hope to abort them before the formation of pus, 
painting the inflamed lump with the tincture of iodine or a strong 
solution of nitrate of silver checks the process of inflammation, 
if applied early. The following is the most efficient solution : 

tjt Nitrate of silver twenty grains 

Spts. nitrous ether one ounce 

Mix and apply to the inflamed surface several times. 

The external application of camphor or alcohol is also recom- 
mended. The best internal remedy is calcium sulphide in pills, each 
containing one-quarter or one-half of a grain, one pill to be taken 
three or four times a day. 

Persons who suffer from a succession of boils will shortly find 
relief from the use of this remedy. In debilitated subjects tonic 
remedies are beneficial, also a change of air, or a residence by the 
seaside. When pus has formed, abortive treatment is useless. If 
the tension and pain are severe, hot poultices afford some relief and 
hasten the process of suppuration. As soon as the boil is soft in the 
center and shows the pus through the skin on pressure of the finger, 
it should be opened or lanced. A little strong carbolic acid introduced 
into the central opening destroys the septic process and hastens the 
recovery. 



THE NEW MEDICAL WORLD. 511 

VIII.— CARBUNCLES. 

A carbuncle, instead of having one central opening like a boil, has 
several or many, for more tissue is involved and it is in every way a 
more serious affection. 

It always occurs in debilitate'! persons, in those whose system has 
been depleted by disease or by chronic alcoholism, or who are other- 
wise enfeebled. The neck and back are the favorite locations for 
this tedious and painful affection. It is a hard, angry looking inflam- 
mation, sometimes as large as a saucer. It is tedious and painful, 
and taxes the vitality to a remarkable degree, often endangering life. 
It is >ometimes called by the laity an ant heap, because of its fancied 
resemblance. It is an elevation containing many little openings 
through which the pus escapes, the tissue under the skin being 
honeycombed by the sloughing process. The danger is from exhaus- 
tion and blood poisoning or Pyaemia, which see. 

TREATMENT. 

At an early stage preventive treatment may be of service. 
Apply the following externally. 

R Spirits of camphor three drams 

Carbolic acid one dram 

Mix and use three or four times a day. 

In the meantime take calcium sulphide in pills as recommended in 
treatment for boils. 

When the carbuncle i> well advanced, the following method of 
treatment has proved eminently satisfactory. 

Inject carbolic acid into the diseased tissue. If little openings 
exi^t, the carbolic acid may be introduced on the point of a silver 
probe into each opening. The object of this treatment is to convert 
a septic, ulcerating mass into a healthy, granulating sore. 

A more thorough destruction of the diseased tissue may be at- 
tempted by making a central opening into the carbuncle scraping out 
the putrid mass, or by inserting a piece of caustic potash about the 
size of a pea. or by pushing a small piece into each opening:. This 
caustic treatment should be followed by poultices to hasten the 
separation of the diseased slough, afterward a dressing of carbolized 
vaseline : twenty grains of acid to an ounce of vaseline should be 
used. 



512 THE NEW MEDICAL WORLD. 

Perfect cleanliness must be observed. The patient's strength 
should be looked after, and the physical vigor maintained. 

IX.— MALIGNANT PUSTULE, OR ANTHRAX. 

This, fortunately, is a disease we seldom see. It is a very danger- 
ous affection, having its origin in the introduction into the human 
system of a specific animal poison of bacterial origin. 

Any material which has been in contact with the disease is capa- 
ble of transmitting it as well as the diseased animal, or eating the 
flesh of an animal diseased with the poison. 

The usual site of the disease is some exposed part of the body, as 
the hands or face. It commences as a small, red, inflamed spot, 
which itches and contains a black point in the center. In a few 
hours a vesicle is formed. On the second day other vesicles form 
about the central vesicle, and the area of inflammation is enlarged 
and more swollen, with a black or brown spot in the center. The 
whole lump of diseased tissue forms a dry, gangrenous slough. The 
whole progress of the disease is rapid, and the mortality is great, 
varying from fifty to seventy-five per cent. The disease begins with 
a chill, vomiting, cold sweat, great depression and anxiety, and ends 
with fever, delirium, muscular spasms and death. 

TREATMENT. 

The treatment should be prompt and energetic. Local treatment 
is often successful if it is early enough to prevent the poison from 
being absorbed into the system. The involved tissue should be 
destroyed by caustic before absorption and blood poisoning take 
place. Make an opening into the center of the pustule and insert a 
piece of caustic potash as large as a pea, or introduce enough strong 
carbolic acid to penetrate the diseased tissues. Either method is 
good treatment. 

A poultice should then be applied to separate the slough, and the 
wound heals, as any healthy sore, by granulations. The destruction 
of the diseased tissue must be thorough. 

When the patient's condition becomes desperate before treatment 
is entered upon, the tendency to death must be counteracted by 
stimulants and other well-known means. Quinine should be given 
internally and the sore dressed with carbolized vaseline. A case so 
desperate should be entrusted to competent medical supervision. 



THE NEW MEDICAL WORLD. 513 

X.— GLANDERS. 

Glanders is a disease of the equine or horse family, of bacterial 
origin, and communicated to man and other animals by inoculation. 

When the disease affects the mucous membrane of the horse, it is 
known as glanders, and when confined to the skin, it is known as 
farcy. 

The disease is characterized by a lump or tubercles the size of a 
pea or less. These ulcerate and discharge pus or matter streaked 
with blood. These ulcers may be numerous and show no tendency 
to heal. 

When the mucous membrane is the seat of the disease, pus streaked 
with blood is discharged from the nostrils. When the skin is the 
seat of the disease, the lumps known as farcy buds, ulcerate form- 
ing abscesses. 

CAUSE. 

Glanders are due to contagion or poison introduced into the system 
by inoculation. Man is not very susceptible to the disease, but it 
may be communicated to him by a horse which is suffering from it. 

When the horse snorts, contagious particles of matter are liable to 
be thrown upon any one who is near by entering the eye, mouth or 
nose or some abrasion of the skin upon the face or hands. The 
disease shows first at the point of inoculation. The period of in- 
cubation is from one to three days. 

SYMPTOMS. 

These are chills, followed by fever, pain in the joints and muscles, 
lameness, profuse perspiration and dark colored urine. The swellings 
are painful, dark red, and look like the inflammation of erysipelas. 
The neighboring lymphatic glands are red, large and tender, and 
show a tendency to inflammation and ulceration. 

The constitutional symptoms which intervene are headache, chills, 
fever, pain in the limbs and joints, nausea, vomiting, diarrhoea, and a 
discharge from the nose which is first watery, but afterwards it 
becomes a viscid catarrh, streaked with blood and of a greenish 
color. 

The mouth and throat are involved, the eyes are inflamed, the 
eruption upon the face becomes a spreading ulcer, and abscesses may 



514 THE NEW MEDICAL WORLD. 

form in other parts of the body. The later symptoms are of a 
typhoid character, as prostration, delirium, stupor and death. 

In some cases the lungs are noticeably involved. The breathing 
is affected, the voice is altered, there is a cough, accompanied by 
expectoration streaked with blood and the breath is fetid. 

TREATMENT. 

The diseased tissues must be destroyed as far as possible with 
carbolic acid, corrosive sublimate, or a hot iron. Nasal ulcers are to 
be treated with creosote, carbolic acid and iodoform. Nitrate of 
silver and permanganate of potash are also used. 

Tonics and stimulants are also needed. This is a horrible disease 
in man, and no effort or expense should be spared to prevent it. 

XL— HYDROPHOBIA OR RABIES. 

In the human race this is a dreaded disease. 

CAUSE. 

It is caused by the bite of a rabid or mad animal, usually a dog. 
The poison is contained in the saliva of the rabid animal, and the 
person bitten is inoculated with it. Unfortunately the mad dog has 
a biting propensity. In order to introduce the poison or contagion 
into the system there must be an abrasion of the skin. 

The period between the inoculation and the appearance of the dis- 
ease is not clearly defined, but from one to two months is given as 
one extreme, and from six months to one or more years as the othei\ 
The great majority of cases develop inside of three months. Moral 
impressions, as fear, fatigue and excesses, seem to favor the out- 
break of this disease. It has been thought by many that those cases 
occurring after several years are influenced by fear and the imagina- 
tion. 

SYMPTOMS. 

The first symptom usually noticed is a sad or melancholy state. 
The nervous system is disturbed and depressed, and the sleep is 
broken. The victim is annoyed by sounds or noises, is petulant, 
fidgety, ill-tempered, unusually irritable, and avoids society. Later 
all these symptoms are exaggerated. An itching or pain is experi- 



THE NEW MEDICAL WORLD. 515 

enced at the site of the wound, the pulse is rapid, the skin hot 
and dry, the appetite is lost and the bowels are constipated. Slight 
convulsions of the muscles take place, the breathing is sighing in 
character. Pain is experienced in the region of the heart, and 
delirium may come on. 

The neck gets stiff, free movement of the head is checked, there is 
a peculiar feeling in the throat, swallowing becomes difficult, and at 
length impossible, the sight of water is distressing and brings on 
shuddering or spasms. The sufferer experiences an intense thirst, 
but upon attempting to drink spasms occur. The countenance is 
anxious and terror stricken, the eyes project and seem to be staring, 
the limbs tremble, the victim looks fierce and strange, and makes a 
desperate attempt to swallow but cannot. 

As the disease advances all these symptoms are intensified, until 
the sight of water or a breath of air brings on a renewal of the con- 
vulsions. The mouth is so parched and dry that the noise made in 
attempting to raise and eject the viscid mucous is compared to the 
barking of a dog. As the thirst becomes more urgent the inability to 
swallow increases. During the paroxysms, which become more fre- 
quent and severe, the patient is violent toward every one about him, 
acts insanely, and has to be restrained. Finally a fatal paroxysm 
takes place and the scene of awful suffering and agony is closed. 
The disease runs its whole course in about three days, usually 
progressing to a fatal termination. 

There are cases where the whole trouble seems to result from an 
extremely sensitive condition of the nervous system ; hence in some 
cases, fear of hydrophobia seems to be the only assignable cause of 
the attack. Listening to the details of this disease may have an 
unhappy effect upon a person whose nervous system is easily excited, 
and hence such a person should be spared the rehearsal of these 
frightful details. There is danger of bringing on hysteria, which if 
not so serious as hydrophobia, is, to say the least, bad enough. 

TREATMENT. 

Preventive treatment is worthy of consideration. Moral suasion 
and even firmness must sometimes be used in the management of 
those who have groundless fears. 

The bite of a rabid animal or wound should be cauterized promptly 
and thoroughly with nitrate of silver stick, or the chloride of zinc, 
to prevent the absorption of the poison. 



516 THE NEW MEDICAL WORLD. 

When the bite is on the limb, it may be corded above the wound 
to prevent inoculation, and the poison withdrawn by immediately 
sucking the wound. The mouth ought to be washed with carbolic 
acid solution immediately before and after the process, but such 
deliberate action is hardly to be expected on such an exciting occasion. 

Ammonia and alcoholic stimulants may be made to saturate the 
system so as to retard the absorption of the poison. For a small 
wound the corrosive sublimate solution is appropriate. Dissolve one 
tablet, such as is used by surgeons and kept by all druggists, in a pint 
of warm water, and thoroughly cleanse and saturate the wound with 
the solution. If this could be done promptly enough, it would avert 
all danger. The patient needs to have confidence in whatever treat- 
ment is adopted for the sake of the moral effect on the nervous system. 

For a fully developed case of hydrophobia, place the patient in a 
dark room and keep him quiet. The spasms may be controlled by 
the cautious inhalation of choloform. Chloral, morphine and the 
bromide of soda are valuable antispasmodics, and may be judiciously 
used. When it is known that a person has been bitten by a rabid 
animal, the advisability of sending the victim to a Pasteur institute 
for treatment by inoculations should be entertained and proper 
medical advice sought in relation to the same. 

The superstition that a person, who has been bitten by a dog, which 
afterwards goes mad, will have hydrophobia is utterly unworthy of 
confidence. 

XII.— TUMORS. 

A tumor is a general name applied to a class of enlargements or 
growths of great variety. They may be composed of various kinds 
of tissue, as muscle, fat, cartilage, bone or blood. They may invade 
any portion of the body, and usually manifest a disposition to grow 
larger, but to this there are exceptions. Tumors seldom, if ever, 
change from one kind to another, and some may occasion no trouble 
or inconvenience. They may grow for awhile perhaps slowly, cease 
to enlarge, and afterwards remain stationary. Such tumors are 
known as benign, or innocent. 

The subject of tumors has been surrounded by considerable ob- 
scurity, The microscope has aided much in their diagnosis and 
classification. 

Tumors differ very much in their structure. The benign, or inno- 
cent tumors, are composed of muscle, cartilage, bone, fat and 



THE XEW MEDICAL WORLD. 5 1 i 

iceous matter. The sebaceous tumors of the scalp, generally 

known as wens, are specimens of innocent tumors. They are often 
called cancers by Belf-styled doctors and impostors, who add to their 
reputation by their successful removal. 

Of all tumors, cancers are the most important, because of their 
malignant character. They not only extend, but they destroy the 
surrounding tissues to such an extent that they eventually destroy life. 

When a cancer is remove'! there is danger of it- returning at the 
same place or in some distant organ. Cancers may occur anywhere 
and involve any tissue of the human body. The most common site 
of their activities is the female breast. A cancer i- t" be con- 
templated always with dread, tor in its worst form the sight i< hide- 
ous, the smell offensive, and the suffering occasioned intense. 

Their cause i- unknown. Soft cancers -ometimes follow an injurv. 

but a larore majority of injuries are unattended by such unfortunate 

.t-. 

TREATMENT. 

There are no internal remedies which can be relied upon to effect 
a cure. Some tumors can he let alone, others should be removed at 
an early date. When removal is decided upon, it should be thorough. 
There are two recognized methods of removal. One i- by corrosive 
applications, and the other is by the surgeon's knife. 

Bef«»re a malignant tumor can be cured, the entire growth must 
be destroyed. Unless all the diseased tissue i- removed, the disea-e 
not only break- out afresh, but is scattered throughout the system to 
reappear in other organs. 

A cancerous growth, that i< superficial, can be effectually cured by 
means of a caustic paste, but for a deep seated cancer of the breast 
"her parts, such treatment is unsuitable, because so much destruc- 
tion of tissue must take place before the diseas _ wth i- reached, 
that inflammatory | sses are awakened and the cancerous growth 

is inflamed ami aggravated. The destruction can neither be rapid 
nor complete, and causes a great amount of pain. Paste and planters 
are suitable only for skin cancers known as epithelial growths. 

The method by external application i< as follows : First the surface 
is denuded with caustic potash, combined with other remedies - 
follow- : 

R Cocaine thirty grains 

Caustic potash ninety grains 

Vaseline one-fourth of a dram 



518 THE NEW MEDICAL WORLD. 

Mix. Apply to one square inch of surface only at a time. This 
produces a denuded surface, to which Marsden's paste should be 
applied. 

5, Arsenious acid two parts 

Mucilage of acacia one part 

Mix into a paste too thick to run. Spread upon the denuded 
surface of the cancer and over it put some dry lint. 

Dr. Marsden has treated over six thousand cases in the London 
Cancer Hospital and is considered excellent authority. Numerous 
pastes are used, containing arsenic or chloride of zinc and pulverized 
blood-root, but such treatment cannot be advised for household 
practice. 

These pastes contain arsenic. They are to be left on from one to 
three days, until considerable inflammation is produced. Following 
the application of the paste, a warm poultice is used, until the slough 
separates, a process requiring about a week, then apply vaseline 
ointment, containing a dram of aristol to an ounce of vaseline, for the 
healing of the wound. 

For cancer in the breast the surgeon's knife is the best remedy. 
It should be applied early, for no treatment will atone for neglect, 
after the cancer lias broken out upon the surface and the surrounding 
glands are involved. Any treatment will then prove disappointing. 

Sebaceous tumors of the scalp should be slit open and the contents 
removed together with the sack or cyst. The same treatment avails 
for the little tumors or cysts upon the eyelids. Tumors about the 
neck and under the ear should be removed with caution, as the large 
vessels in these regions render surgical operations unusually hazard- 
ous. 

Soft cancers may develop as the result of some injury. Their 
growth is usually rapid, and successful treatment is unusually difficult. 

Birth marks are vascular tumors, composed of enlarged blood ves- 
sels, often situated about the face, and their removal risks a scar or 
disfigurement as unsightly as the red or purple spot itself. Some- 
times they have been treated by the injection of iron or ergot, with 
the hope of obliterating them. Their removal has also been sug- 
gested by making them the site of a vaccination. 



CHAPTER XXXII. 
MARRIAGE AXD MATERNITY 



I. — Marriage. II. — Reproduction. III. — Symptoms of P: 
nancy. IV. — Diseases of Pr: v V. — Advice . 

the Pregnant. VI. — M> lrriage. Vli. — L a, Si 
and Management. VIII. — Management of Infas - 

IX. — Care and Eduoa f Childf.ev 

[.—MARRIAGE 

THE subject of marriage in its relation to the maintenance 
transmission of sound health Lb f fi ;:h vital important 
serve more than a passing n'»t: 

Many say that poverty burdens life with anxiety, tills it with 
drodg ind renders a fruitful mama_ a eiallv oppressive; but 

the courage, hope ami love, of a properly we pair cai 

outlive and over such an objection. 

verty is 1 reared but little in comparison with some of the 

hereditary and destructive ses, ^ uilis, which continues 

down through the _ a r outlived and n- per- 

petual blight and curse, the transmission of which is but the 

n of the wail of weakness and sorrow. Any one can - 
. that wealth m en fails t«> produce happiness for the mar- 

ried -rate than its opposite. Even where then sts 1 ssess 

of all that money can buy. there must also be the - ritioi 
mutual helpfulness, that delicate sympathy, that indes 

•ndition. without which there can be no charm, no happii ss, 
and do home. Idle indulge . and various luxu s, 

become tiresome, de<ire tails, ti. rite tails, and life is full of 

an itude and complaining 

It i< the busy mother, surrounded by her tre- and interest- 

ing g children, with no time for weariness, no 



520 THE NEW MEDICAL WORLD. 

complaint, hands full, heart full, life full, of all that is beautiful, 
noble and inspiring, who is to be envied rather than the complaining 
daughter of wealth, who appears to be satisfied with a poodle. 

To contemplate marriage simply for support, or to be relieved from 
labor, without any intention of contributing to the success of the 
enterprise will prove disappointing. 

The young man who casts love aside and contracts an unsuitable 
commercial marriage, consenting to be a sort of genteel servant in 
order to be shielded from the struggle of earning a living, deserves 
little sympathy and usually gets less. 

The woman who marries with mercenary or wrong motives is sure 
to find a place for repentance with many tears. Much depends upon 
the wife in that subtle process of home making, and however 
limited the means, she must be able to fill the heart of her husband 
with satisfaction. If he is allowed to toil without sympathy and his 
earnings are carelessly squandered, sooner or later he will lose his 
courage, and for such a wife disaster is in store. 

Marriage implies that earnest attention should be given to those 
matters which have a bearing upon the important subject of repro- 
duction. Those persons ought not to marry who are unwilling to 
fulfill to a reasonable degree the obligations involved. The legitimate 
consequences of marriage should be previously understood, and 
manfully and heroically undertaken. Marriage is justly termed the 
foundation of society, because it has in view the constant renewal of 
the race and hence its perpetuity- Human beings ought to live and 
act wisely both for their own and for posterity's sake. Children are 
the most precious gifts bestowed upon lawful wedlock. They ought 
to be strong enough to outlive their parents, and virtuous enough to 
perpetuate and improve upon their moral qualities. 

Fitness for marriage, compatibility with each other and surplus 
vitality to transmit, are some of the necessary considerations which 
outweigh in their importance, such other minor considerations as 
wealth, station or social position. 

\Ve are frequently told that the modern requirements of refined 
society are so exaggerated that it requires a fortune to raise a single 
child, and a very extensive one to raise a group of children. These 
exactions are so emphasized, that there appears to be some reason for 
believing that there is good excuse for thwarting the results of wed- 
lock, on the part of those who say that they cannot afford a family. 
There is but little ground for such frivolous excuses. It is not neces- 



THE NEW MEDICAL WORLD. ")21 

sary to conform to all the whims, fashions and foibles of modern 
society. The standards which it maintains are often artificial and 
detrimental, if not suicidal, to the welfare of the race. Many of the 
most brilliant and talented persons which the world has ever known, 
have been strangers, at least in early life, to the luxuries now so 
common and considered so essential. They were not born in houses 
with a brown stone front nor surfeited with Porter-house steak. 

A measure of struggle and hardship is favorable to life and its 
best development, while idleness and luxury are unfavorable and 
often destructive. Inertia is death both physical and moral. Activity 
is the law of life, and when coupled with a vigorous struggle, it 
develops self-reliance and a strength of character such as was never 
dandled in the lap of ease. 

Much fault is found with our unequal social conditions, and there 
is much murmuring and complaint. Vast accumulations in the hands 
of a few, resulting from speculation in food products, questionable 
shrewdness and combines to squeeze the people, are unfortunate and 
deplorable. They foster envy and a growing discontent on the part 
of the masses. 

j\ t o w r onder they think the world is out of joint, when some mil- 
lionaire in a great city spends a thousand dollars upon a dog house, 
while the unfortunate child goes barefoot and sleeps in a dry-goods 
box. But it is to be remembered that fortune is so fickle that 
the same barefooted boy may become wealthy and the millionaire 
spendthrift may close his life in an almshouse. 

Perhaps these inequalities will be remedied in the future and the 
excessive accumulations of wealth be prevented by legislation. As 
specific remedies- are found to check the devastation of contagious 
diseases, so we may hope that the intelligence and enterprise of our 
young nation will be able to devise just methods to check the 
growth of all its evils. 

At any rate these things do not render it necessary for an in- 
dustrious man and woman to work so hard for shelter, warmth, food 
and clothing, that they are obliged to turn their backs frowningly 
upon the best gift that God ever bestowed upon a married pair. 
This is a broad and productive land, and there is no such grinding 
poverty here as in the old world. The vast accumulations, that make 
people envious, often render the posterity of the rich physically and 
morally effeminate and tend to the obliteration of their name and 
place, so that their wealth is again scattered. Admitting the truth- 



522 THE NEW MEDICAL WORLD. 

foulness of every complaint, our social conditions are not depressing 
enough to deter young people from marriage who are strong and 
brave, and with whom the current of love is deep, clear and pure. 

The simpler life is made, and the more it is conformed to natural 
laws the more satisfactory it is in the end. 

The modern drift from the country to the city is unfortunate, 
unnecessary and unwise. Many are allured by the attractions of the 
city to leave the old homestead and become toilers in the shops and 
mills. They pay as much for a contracted lot of a few feet front as 
the farm and its buildings included if sold would bring. A few of the 
more fortunate perhaps better their condition, but the majority sur- 
render their independence and enter upon a struggle just for their 
daily bread. The pleasure and independence of country life ought 
to be emphasized. It is the favored place for making a home. The 
air and the water are pure and free, restraints are less burdensome 
and living is more natural and simple. It is the ideal place for chil- 
dren. They thrive better, are more healthy, hardy and moral, and 
make better men. They cost less to raise, and if less polished they 
have greater physical endurance, and are not wanting in the neces- 
sary refinements of mature years. 

Marriage at an age as early as is consistent with the ability to 
provide a home and the necessities of home comfort should in every 
way be encouraged. The suitable age for the young man is some- 
where in the vicinity of twenty-five years, and for the woman 
it may be from three to five years younger. At these ages 
young men and women are sufficiently mature to enter upon 
the responsibilities of married life, and are much more likely 
to make it a success than if married earlier or later. Marriage, fol- 
lowing long engagements or numerous courtships, does not promise 
as well for obvious reasons as when entered upon during the fresh- 
ness and enthusiasm of early life. Hence early marriages should be 
encouraged in every possible way as the basis of good society. There 
is no more pleasant or invigorating struggle, than that of battling 
with the world, for the purpose of getting ahead in it, with necessity 
impelling you, and hope beckoning you forward. The requirements 
of life should be so simplified that the young man and woman may 
have courage to start in that delightful process of home building 
with every promise of success. 

The so-called social evil is a blighting curse, destructive to morals 
and every virtue. It should obtain no license, and toward it no 



THE NEW MEDICAL WORLD. 523 

protecting hand should be extended. It boastfully soils with its 
touch the innocence and modesty of either sex, never satisfied till it 
has wrought their degradation and ruin. 

Whether single or married self-control and self-mastery should be 
acquired and practiced in the exercise of the sexual functions. Their 
only disclosed object, the perpetuity of the race, should be faithfully 
considered. Apart from this they are scarcely necessary. Their 
exercise is neither essential to health nor enjoyment. Little if any 
harm results from holding the sexual activities in abeyance even for 
a life time, and under the favoring conditions offered by marriage, 
great moderation is alike conducive to health and happiness. 
. The perversion of this instinct is fatal alike to purity and peace, 
for it disturbs the nervous equilibrium, undermines the health, sours 
the disposition, fills life with suffering, and digs an early grave. It 
often leads the unmarried to the gateway of destruction and the 
married to divorce rmd degradation. 

II.— REPRODUCTION. 

The product of conception is carried in the womb for about two 
hundred and eighty days, during which time it is perfected and 
developed so as to maintain subsequent to birth an independent 
existence. This is the period of pregnancy; its commencement 
is conception, and its termination labor. 

This period usually begins with the close of the last menstruation 
or monthly sickness, and ends in about nine calender months, or to 
be more precise, in two hundred and eighty days. Living beino-s 
thus reproduce themselves, for the perpetuity of the race could not 
otherwise be maintained. 

The process is sexual, and requires the energizing force of both 
the male and the female. The female has two ovaries, one on each 
side of the uterus, each about the size and shape of an almond. The 
ovaries produce at stated intervals of about twenty-eight days a little 
ovum or egg, so small that two hundred of them would measure but 
little over an inch in diameter. When the eirii' is matured it bursts 
the outer covering of the ovary and is carried along a little tube 
so small that its central opening will admit only a common bristle. 
This is known as the Fallopian tube or oviduct, and opens one 
on each upper side of the womb. The matured egg passes alowlv 
along this tube till it reaches the womb. If conception takes place 
during its journey it attaches itself to the womb and draws nourish- 



524 THE NEW MEDICAL WORLD. 

ment from it until the development of a human being is accomplished. 
Otherwise it perishes. 

These different stages of development are of great interest to a 
scientific mind, but must be passed over here for the most part, as 
the details of reproduction are too extensive and complex except for 
a technical work. Coincident with the escape of an egg from the 
ovary, a discharge of blood from the interior of the womb takes 
place. This occurs once a month in a healthy mature female, and i& 
known as menstruation, or the monthly flow. In order that concep- 
tion may take place it is necessary that spermatozoa, which are con- 
tained in the semen secreted by the male, should come in contact 
with the egg somewhere on its passage from the ovary to the 
uterus. Seminal fluid is secreted by the testicle of the male and con- 
tains large numbers of micro-organisms called spermatozoa. These 
little agents are active and capable of rapid movement, and if sup- 
plied with warmth and moisture retain their vitality for a number of 
days. If these little bodies are deposited anywhere within, or near 
the vagina, they are likely to find their way into the womb and the 
Fallopian tube in search for the egg. 

Having found the little ovum or egg, they penetrate it with great 
energ}^. Their mission is then completed, and conception takes 
place. Conception may take place at any time during the month, 
but is most likely to occur just before or soon after menstruation. 
The impregnated ovum goes through a series of rapid changes. First 
there is division and subdivision of the egg, until it resembles a mul- 
berry, then layers of membrane are formed, some of which begin to 
organize into a rudimentary being, and others form a sac to surround 
and protect it. A placenta is formed with its cord, fluid surrounds 
the perfectly formed embryonic child, and all this mysterious work 
is accomplished by the end of the third month. From this time 
onward to delivery, constant growth of the foetus takes place, and 
the womb enlarges correspondingly to meet the growing demands of 
its occupant. The umbilical cord when fully developed is about 
twenty inches long and about the size of an adult finger in the 
diameter. It connects the growing foetus to the placenta and contains 
a vein and two arteries for transporting blood to and from the foetus. 
It is in the placenta that the foetal blood is oxygenized and rendered 
fit to be returned to the foetus for further nourishment. The foetus 
and cord are protected from pressure and injury by the amniotic 
fluid which the membranous sac contains. 



THE NEW MEDICAL WORLD. 525 

When the term of pregnancy is completed, labor takes place, and 
a new being* is born into the world. Labor is accompanied with 
pains and an uncomfortable bearing down sensation. These pains 
are not continuous, bnt come on at intervals. The early pains of labor 
are due to the dilation of the mouth of the womb. If its muscular 
tissue is rigid, they may continue for a long time, and may be 
especially severe and annoying. At birth a well-developed child 
measures about twenty-two inches in length and weighs from six to 
seven pounds, although they sometimes weigh much less or consider- 
ably more in individual cases. 



III.— SYMPTOMS OF PREGNANCY. 

The early symptoms of pregnancy are largely probabilities, but 
when great interests are at stake a skillful practitioner will be able to 
give even in these cases satisfactory opinions and. counsel. 

The first and best known symptom of pregnancy is suppres- 
sion of the monthly sickness. This is the rule, and exceptions are 
rare. If there is a previous history of good health, and the woman 
has heretofore been regular, and nothing has occurred of sufficient 
moment to otherwise account for the cessation, the probability of 
pregnancy is strong. 

Nausea and vomiting are often anno}*ing symptoms during early 
pregnancy, usually commencing about the fourth week and ending 
during the second month. This symptom is commonly known 
among women as morning sickness. Sometimes the patient feels 
hungry and eats heartily, vomiting immediately after, without dis- 
comfort. There are cases where this symptom does not appear at 
all, and others where it is only slight, and still others where it is 
very severe and aggravated, continuing on through consecutive 
weeks, both day and night, until it threatens life. 

Pt} T alism, or an increased flow of saliva, is sometimes troublesome 
during pregnancy, the secretion of the salivary glands being very 
greatly increased above the normal. 

Enlargement of the veins of the legs is one of the early symptoms 
of pregnancy, owing to the increased tension of the blood vessels 
during- this condition. 

Changes take place also in the breasts. They become enlarged, 
tender, and somewhat painful. The circles called the areola, around 



626 THE NEW MEDICAL WORLD. 

the breasts, become darker, and when a secretion of milk is discov- 
ered there is very strong evidence of the pregnant condition. 

The abdomen, after the second month, gradually enlarges, and this 
symptom is so well understood as to require no explanation. 

At the end of about four months the prospective mother begins to 
feel the movements of the foetus. These movements, known as 
quickening, are at first feeble, but constantly become stronger. It is 
a great error to suppose that life does not exist prior to quickening. 
This symptom is usually considered a positive sign of the pregnant 
condition, and unless such movement is imagined or feigned, should 
be so regarded. 

There are some other symptoms, as the sounds of the foetal heart, 
ballotement, the uterine souffle, etc., which are of interest only 
to professional persons, and need not be described at this point. 
The obscure symptoms require attention from the skillful ear and 
hand of tne physician. 

In general, time unveils obscurities and brings to light and ex- 
plains many mysterious secrets. Unless for some reason it is neces- 
sary to at once recognize the fact of pregnancy, a little judicious 
waiting is recommended. 



IV.— DISEASES OF PREGNANCY. 

The diseases of pregnancy are in some cases simply an exaggera- 
tion of the symptoms already mentioned, as nausea and vomiting, 
varicose veins, dropsy of the feet and legs, and hemorrhoids or piles. 

Nausea and vomiting are among the most common troubles of 
pregnancy, and they sometimes persist till the vomited matter is 
streaked with blood, and the stomach manifests symptoms of inflam- 
mation. When the nausea is constant, the patient loses flesh, 
looks haggard, and the mere sight or odor of food is sufficient to 
provoke renewed attacks. 

The mild cases require but little treatment, for the symptoms pass 
off with the forenoon, and in a few weeks all traces of sickness 
disappear. A cup of coffee and a slice of toast taken each morning 
in bed will frequently afford relief. If there is an acid condition of 
the stomach, a dessert spoonful of the granular citrate of magnesia 
dissolved in water will be beneficial. A mustard plaster applied over 
the pit of the stomach will often afford relief in aggravated cases. 



THE NEW MEDICAL WOBLp. 527 

When other nourishment cannot be retained, equal parts of lime 

water and milk may l>e tried. The following powders arc excellent 
and have usually afforded relief in the author's practice. 

^ Cocaine muriate two grains 

Bismuth subnitrate forty grains 

Cerium oxalate forty grains 

Pepsin pure forty grains 

Mix. Make into twenty powders. Take one powder after each 
meal or after vomiting. 

Sometimes the vomiting is bo severe that the hypodermic injection 
of morphia for a time, in one-eighth grain doses, is essential to produce 
rest. This treatment, however, should only be attempted by those 
possessing professional skill. 

If constipation is troublesome, and is not relieved by using fruits 
and vegetables in the diet, the citrate of magnesia or a Seidlitz 
powder each morning, or a teaspoonful of the compound liquorice 
powder may be taken each night on going to bed. If the tongue is 
furred, the breath foul and the skin sallow, some more energetic 
remedy to act upon the liver may be required, and for this purpose 
the following is recommended. 

I* Podophyllin one grain 

Solid ext. mix vomica four grains 

Ext. taraxacum twenty grains 

Ext. cascara sagrada twenty grains 

Pulv. zingiber ten grains 

Mix. Make twenty pills, take one each night, until the bowels 
act naturally. 

Piles or hemorrhoids are sometimes caused by the pressure of the 
gravid womb upon the veins, and also the increased blood pressure 
due to this condition. A suppository pushed into the rectum, after 
the bowels move, or one each night and morning, will afford relief. 

The following is recommended : 

r} Cocaine muriate two grains 

Ext. hvoscyamus live grains 

Pulv. opii live grains 

Tannin ten grains 

Cacao butter q. s. to make ten suppositories 



528 THE NEW MEDICAL WOULD. 

Use as indicated. An ointment made of galls and opium often 
affords relief. Sometimes hot fomentations are soothing to piles that 
are inflamed. 

For an excessive flow of saliva use an astringent wash, containing 
alum and tincture of myrrh as follows : 

5, Alum twenty grains 

Rose water two ounces 

Tinct. of myrrh one dram 

Mix. Use to rinse the mouth as needed. 

The enlarged veins of the lower extremities may be emptied and 
relieved by taking the recumbent position frequently and having the 
limbs raised higher than the head, or placing the feet in a chair when 
sitting. If the limbs persistently swell, attended with headache, the 
urine should be examined to see if albumen is present. 

When there is a large amount of albumen in the urine of a 
pregnant woman she needs medical attention, otherwise puerperal 
convulsions are likely to come on before, during, or after labor. 

Neuralgia, due to decayed teeth or from some other obscure 
cause, is of common occurrence, and is often persistent and trouble- 
some. To extract the painful tooth rarely gives relief, as some 
other tooth is likely to continue the torment. Hot applications may 
be applied to the seat of the pain. Menthol liniment may afford 
relief or chloroform applied locally. If neuralgia is due to anaemia 
and an impoverished condition of the nerves, tonic treatment in- 
ternally will yield better results than external applications. 

1^ Quinine sulph. one-half dram 

Ext. nux vomica four grains 

Dried sulphate of iron ten grains 

Ext. hyoscyamus ten grains 

Mix. Make into twenty pills. Dose one at night and repeat 
in four or six hours if not relieved, taking three a day until im- 
provement takes place. 

Fainting sometimes occurs and is due to emotion, excitement or 
weakness. The patient should be placed carefully upon a bed or 
lounge, the clothing loosened and ammonia or spirits of camphor 
inhaled. A teaspoonful of the aromatic spirits of ammonia, diluted 
with water, should be given internally, and may be repeated at inter- 
vals till the tendency to fainting is relieved. 



THE NEW MEDICAL WOULD. 529 

The pregnant woman often experiences a great variety of distress- 
ing nervous symptoms, as insomnia, irritable temper, headache and 
cough or difficult breathing. Unless these symptoms are aggravated, 
thev pass off in due time and require but little treatment. 

Chorea sometimes occurs as a complication of pregnane}', and 
when it does, requires professional advice, as it is rather an unfavora- 
ble accompaniment. It is best treated with the bromide of iron and 
Fowler's solution. 

Where there is irritation of the bladder, or inability to hold the 
water in the pregnant condition, it is due to the pressure of the 
womb upon the bladder or upon the urethra, or a too-acid condition 
of the water. Relief is afforded by the reclining position, and by 
alkaline drinks, as bicarbonate of soda or the granular citrate of 
potash. 

Other rare derangements may occur in pregnancy, rendering it 
necessary to seek medical advice. 



V.— ADVICE TO THE PREGNANT. 

A pregnant woman ought to desire that method of life which will 
best prepare her for the trials of maternit}\ She should consult not 
only her own health and comfort, but also pursue such a course as 
w T ill be likely to insure the birth of a healthy offspring. 

In regard to exercise, only that of a moderate type should be enter- 
tained. Physical and mental fatigue should be avoided. Fresh air 
and sunshine are healthful, and the pregnant woman should be 
encouraged to go out of doors daily. The occupation of the mind 
with domestic duties is natural and invigorating. A cheerful and 
hopeful disposition should be cultivated, and friends should do their 
part to contribute to this result. 

Excitements should be avoided, as well as excessive weariness. 
Late hours, public entertainments, dancing, horseback riding and 
fatiguing journeys, involve too much risk and ought to be in- 
dulged in, if at all, very cautiously. Any indication of hemorrhage 
or pain, or premonition of miscarriage, should at once suggest the 
necessity of absolute rest. 

The food should be simple, varied, nutritious, and sufficient in 
quantity and quality to satisfy the appetite. Xew demands are 
made upon the system which must be met by an increased, amount of 



530 THE NEW MEDICAL WORLD. 

nutrition, otherwise the strength will be impaired. A proper atten- 
tion to the diet will keep the bowels free and the health up to a 
vigorous standard. 

Fruits are excellent. Nearly all kinds are healthful in their 
season, and if used freely tend to prevent those unnatural cravings 
which are sometimes a source of considerable anxiety. Highly 
seasoned foods and alcoholic stimulants should be rigidly excluded. 

Regularity in all the habits of life should be maintained as far as 
possible, and sufficient sleep secured. Personal cleanliness should be 
observed, and every tendency to despondency overcome by a cheer- 
ful spirit, pleasant and agreeable occupation for the mind, and a life 
of activity and hope. 

To employ the mind frequently in literary pursuits is prefer- 
able to giving way to melancholy. In this way the stamp of greater 
intelligence may be affixed to the offspring and hope kept foremost in 
the prospective mother's contemplations. Remember that although 
maternity is often a severe trial, it is the crown and glory of woman- 
hood. Every true gentleman or lady w T ill treat a woman in the 
pregnant condition with the utmost kindness, courtesy and respect. 

During pregnancy loose and comfortable garments should be 
worn, and in every known way health, cheerfulness and comfort, 
.should be secured. Let reason preside over the passions. It ought 
not to be necessary to observe that intercourse during pregnancy 
is. unnatural and often productive of much harm. At such a time 
reason and prudence should prevail, and neither a woman nor 
her offspring should be imperiled to gratify any instinct which has 
already received its full accomplishment in the pregnant condition. 

VI.— MISCARRIAGE. 

For various reasons, miscarriages are liable to occur at any time 
during pregnancy, anywhere between conception and the seventh 
month. 

Where labor occurs between the seventh and ninth month, it is 
known as premature labor, but the child, though requiring more care, 
is mature enough to live and maintain a separate existence. Previous 
to the seventh month a child is rarely known to live. A woman who 
is pregnant for the first time is not as likely to miscarry as one who 
has borne several children. Very fleshy women and those who men- 
struate profusely are more likely to miscarry than others. 



THE NEW MEDICAL WORLD. 531 

The causes of miscarriage are numerous. Some of the more 
common are an attack of some acute disease, as measles, scarlet 
fever, pneumonia, typhoid fever, intermittent fever, dysentery; some 
excessive emotion or excitement, violent exercise, falls, blows, in- 
flammation of the womb, intercourse, violent purgative medicines; 
these or similar causes may provoke miscarriage. 

Syphilis is a very common cause of miscarriage. Lead poisoning 
sometimes leads to the same result. The author has found syphilis 
and fatty placenta most frequently the cause. 

The first symptoms of an approaching miscarriage is hemorrhage. 
This may be slight or profuse. When pain and hemorrhage are both 
present, a miscarriage is most likely to take place. An attempt 
should be made to ward off a threatened miscarriage by perfect rest 
in bed and an unstimulating diet. Cold drinks should be used and a 
sedative taken as a five-grain Dover's powder. This may be repeated 
two or three times if needed at intervals of four hours. 

After the third month miscarriages often result in an incomplete 
emptying of the womb. Should any portion of a placenta be 
retained, it is likely to occasion troublesome hemorrhage and suggests 
another danger, blood poisoning, from the decomposition of this 
retained debris. Miscarriages are often attended with a large degree 
of pain sometimes equal to that of labor at full term. 

Miscarriages are common at the close of the first month of preg- 
nancy, and are more frequently overlooked than recognized, as the 
only symptom is bloodclots and an increased amount of hemorrhao-e. 

Miscarriages criminally procured are to be deprecated, and any 
man or woman carrying on such unrighteous business, should be dealt 
with as a base criminal. The principles to be observed in a threatened 
miscarriage are rest, cold drinks and cold applications to check 
hemorrhage. If hemorrhage and pain persist, a physician will be 
needed to manage the case. 

After a miscarriage has taken place, rest should still be enjoined 
as after labor at term, in order to avoid the many risks which follow. 
Hemorrhage, inflammation, uterine weakness and displacements are 
some of the consequences which may follow, Avhen rest is not properly 
enjoined or when the injunction fails to be obeyed. 

VII.— LABOR, STAGES AND MANAGEMENT. 

Labor is a natural or physiological process. It terminates the 
period of pregnancy after about two hundred and eighty days. 



532 THE NEW MEDICAL WORLD. 

Sometimes it commences abruptly, but more often there are various- 
premonitions. During the last two weeks of pregnancy the abdomen 
seems to settle down somewhat, so that there is less interference 
with the act of breathing, and walking about is performed with less 
discomfort. Toward the termination of pregnancy uterine contrac- 
tions take place. At first these are painless and scarcely noticed, 
but after a time they begin to become painful, and when the} r take 
place and continue at regular intervals, labor has commenced. These 
pains are caused by the muscular contraction of the uterine fibers. 
Spurious pains may take place, and are often caused by indigestion, 
constipation, or colic from a collection of gas in the bowels. Spurious 
pains may be relieved by hot or carminative drinks, a dose of 
castor oil, or some other mild cathartic. 

The beginning of labor is usually distinguished by a discharge of 
bloody mucous, which results from the expansion or stretching of the 
mouth of the womb. As labor progresses the pains become harder 
and more regular. In order to fully understand this important sub- 
ject, it is customary to describe it under three distinct stages. 

The first stage of labor is often quite lengthy and tedious, and 
lasts till the mouth of the womb is fully extended, so as to permit the 
expuloion of its contents. This is often the most trying portion of 
labor, the pains are usually aggravating, the patient is uneasy, fret- 
ful and nervous, and forebodes evil. She seeks for rest or comfort in 
a changed position, but finds it not. If the mouth of the womb is 
inelastic and reluctant to distend, this stage of labor is correspond- 
ingly prolonged. During a pain a portion of the enveloping sac, 
filled with fluid, is pressed into the mouth of the womb, and seems 
to assist favorably the dilating process, for it is often noticed that 
when this sac ruptures and the amniotic fluid escapes early, the 
progress of labor is retarded, and the first stage is not only longer, 
but more tedious. 

Near the completion of the first stage of labor the bag of waters 
ruptures and the fluid pours out with a gush. The completion of the 
first stage is often attended with shivering, slight nervous chills and 
vomiting. These are of no special consequence and should not be 
regarded as unfavorable. 

The second stage lasts from the complete dilation of the mouth of 
the womb to the expulsion of the child. The head descends quite 
rapidly into the pelvic cavity. The bag of waters having ruptured, 
the womb is able to contract with more energy. The woman now 



THE NEW MEDICAL WORLD. 533 

becomes possessed of more courage and is inclined to grasp hold of 
some object with her hands and pull. Meantime she holds her 
breath and bears down, thus assisting herself by the voluntary con- 
traction of the abdominal muscles. During this period of labor 
cramps of the legs sometimes occur, and the back feels as if it would 
break, but these are relieved, the former by rubbing and the latter 
by pressing the hand hard over the portion of the back where the 
pain is experienced. 

Powerful uterine contraction takes place, followed by intervals 
during which a little rest is obtained. Unless there is some impedi- 
ment or obstruction to labor, the head, which commonly presents, is 
soon born and the child's body easily follows, completing the second 
stage of labor. 

The third stage consists in the delivery of the placenta or after 
birth which generally follows labor in fifteen or twenty minutes, and 
causes but little suffering. The uterus after the birth of the child, 
contracts upon the placenta and detaches it from its temporary loca- 
tion. Failure of the womb to contract firmly, allows free hemorrhage 
to take place, and is one of the greatest dangers following child 
birth, which the experienced physician always guards against. The 
womb when firmly contracted after deliver}^ can be felt through the 
abdominal wall, as a hard round ball, about the size of the child's 
head. The delivery of the after-birth and contraction of the womb, 
terminates the third stage of labor. 

Most cases of labor are easily managed, and when no troublesome 
emergencies arise, no especial skill is demanded. Labor is a natural 
process, and the majority of cases could be left to nature without 
risk. If it was not for exceptional cases, a nurse or midwife could 
manage a case of labor as well as a physician. Labor is, however, 
sometimes associated with unexpected accidents and unforeseen 
emergencies, and if no provision is taken to prepare for any possible 
difficulty or peril, a valuable life may be sacrificed in consequence. 

It is safe and better for all concerned to have a reliable physician 
engaged, so as to be prepared to meet promptly any unfavorable 
events. A seasonable engagement enables the physician to ward off 
any threatening dangers by timely and appropriate attention. 

There are no medicines which can be given in advance to ensure 
an easy and safe delivery, although such specifics are unscrupulously 
advertised and offered to human credulity. 

The room selected by the prospective mother should be quiet, away 



534 THE NEW MEDICAL WORLD. 

from confusing noise of the street or household. One of the best 
qualifications a nurse can possess is good sense, coupled with a quiet 
and cheerful spirit. The patient should not be kept in bed during 
the first stage of labor, as sitting up or walking about, favors the 
descent of the foetus into the pelvic cavity. The physician can judge 
quite accurately from the condition of the mouth of the womb, 
whether or not labor is much advanced, and whether it will be easy 
or difficult and tedious. Often the greatest hindrance to labor is the 
rigidity of the mouth of the womb. 

Rectal injections of warm water, castile soap and olive oil should 
be given if the bowels are loaded. Bearing down does no good in 
the early stage of labor and ought not to be encouraged as it dissipates 
the strength which will be needed later. 

If the bag of waters is not ruptured by the completion of the 
first stage of labor, the membrane should be broken by the finger 
nail or in some other appropriate way. When the patient enters 
upon the second stage of labor it is time for her to take the bed, a 
mattress is preferable to a feather bed. 

The necessary preparations are a rubber cloth under the hips and 
over this, a folded quilt and sheet, to absorb the discharges. The 
nightdress and other clothing should be drawn up under the arms. 
The position most favorable for labor is lying upon the left side or 
upon the back, as is most comfortable. 

Whether it is necessary to use ether or chloroform during the 
second stage of labor, must be left to the discretion of the attending 
physician. The judicious use of these agents, in the hands of an 
experienced practitioner, are never attended by any untoward 
results. To obtain rest between the pains is of great importance to 
the patient and should be encouraged. 

Drinks to relieve thirst, or for the purpose of nourishment, may be 
administered as the condition of the patient requires. Everything 
which will be needed should be in readiness, so that there may be no 
haste or confusion, as a silk or strong cotton cord, scissors, hot 
water, and a warm blanket or woolen shawl to wrap about the 
infant. 

The cord is sometimes twisted about the child's neck. It should 
be drawn down gently and slipped over the head. When the child 
is born it must be placed in a position favorable for breathing. The 
cord ought not to be tied, till it has nearly stopped pulsating, and it 
may be left for some time in perfect safety if the expected physician 



THE NEW MEDICAL WORLD. 535 

lias not arrived. Firm pressure can be made over the womb by an 
experienced nurse, which will aid the uterine contractions, prevent 
hemorrhage and assist in the delivery of the after birth. If the 
placenta does not follow in a few minutes after the birth of the child, 
the womb should be grasped in the hand through the abdominal 
wall, and sufficient pressure made to press out the after birth. 
Sometimes, though rarely, it is necessaiy to introduce the hand into 
the womb in order to separate it. Strong traction upon the cord 
should not be made, as injury might be done in this way. When all 
of the above suggestions have been completed, the soiled clothing 
should be removed, the woman sponged off and dry, warm sheets 
and napkins should be made use of, to make her comfortable, and ad- 
ditional covering should then be thrown over her, when she should 
be allowed to rest. 

If a bandage is made use of it should extend well down on to the 
hips and be fastened tightly enough to afford support without being 
uncomfortable. If there is a tendency to excessive hemorrhage the 
head of the patienjt should be lowered, a clean muslin handker- 
chief, wet in equal parts of vinegar and water, pushed into the 
vaginal space, and a half teaspoonful of the fluid extract of ergot 
should be given internally. 

A desire for food on the part of the delivered woman should 
be gratified by some nourishing drink ; much depending upon previous 
habit as to the character of food which may be allowed. She cer- 
tainly should not be starved, nor on the other hand over fed. She 
must not be treated as a criminal, with bread and water diet, but 
must have food sufficiently nutritious to strengthen her exhausted 
forces. 

Attention may be given to the nipples before labor, to harden them 
and to prevent their cracking or becoming sore, the result of nursing 
an infant. The glycerite of tannic acid which is simply tannin, 
dissolved in glycerine by the aid of heat, may be applied daily for 
three or four weeks before labor which will toughen them. Should 
they become sore from the lack of such precaution, the same 
remedy may be applied to heal them. Before the infant nurses, 
the breasts should be carefully washed, as the remedy is very bitter. 
After the infant has nursed, the nipples should be washed again and 
dried before applying the remedy. 

When a child is still born, or fails to survive, the secretion of the 
mother's milk is sometimes excessive and troublesome. In most 



536 THE NEW MEDICAL WORLD. 

cases, if the breasts are let alone, nature will absorb it without any 
harm resulting. - It is well to avoid liquids as much as possible, and 
take a tablet of T ^ of a grain of atropia three times a day to check 
the secretion of milk, and belladonna breast plasters may also be 
used. 

VIII.— MANAGEMENT OF INFANTS. 

The infant is the mother's greatest and best gift. It brings a 
large amount of love along with it, and awakens new thoughts, and 
broadens the plans and outlook of the parents. A new world of 
being springs into activity, involving new thoughts, broader action 
and sweeter and purer life. The happy pair have now a human 
being, a part of themselves to live for and to love in common. 
This gives to life a new zest and a wider outlook. Mother love is 
strong and pure ; it is the safeguard of the little stranger. Mother 
instinct has anticipated the arrival, and prepared for its advent 
warm flannels, blankets, slips, napkins, and whatever else she has 
learned will be needed in order that the welcome of the newcomer 
may be hearty and fitting. 

Sometimes it happens that the baby enters the world before the 
arrival of the expected doctor ; when this occurs, it need cause no 
excitement. It must be remembered that a new-born child must be 
able to breathe. It must have air, and hence must be lifted up into 
a position favorable for respiration. The cord ought not to be tied 
for two or three minutes, and need not be for some time, not until the 
infant has breatned, has cried lustily, and the pulsation of the cord 
has nearly ceased. Take a strong string and tie the cord tightly 
about two inches from the body of the child, at about three inches 
])lace another tie, and sever the cord between the two knots with a 
pair of scissors. The cord should be wrapped in a piece of absorbent 
cotton and laid over the left side of the child and held in place by a 
band. Before this is done it should be washed in the following man- 
ner : Rub it over quickly and thoroughly with warm sweet oil or vase- 
line which has been poured upon the palm of the hand, then rub it 
quickly again with a piece of soft muslin, and arrange and put on the 
clothes. The oil renders the skin soft and natural. The head, face 
and eyes, should be washed clean with a sponge or soft cloth and 
warm water, after the baby has been dressed. This method in winter 
prevents taking cold, from too great reduction of the temperature. 



THE NEW MEDICAL WORLD. 537 

When the body of the child is washed in water, which may be 
done in summer if preferred, it should be done by immersing the 
infant in a warm bath, keeping only the head ont of the water, 
scrubbing it briskly meantime with the hand. After the bath 
it should be rolled up in a woolen shawl or blanket. Care must be 
exercised to ascertain if the circulation of the newly-born child has 
been properly established, and to see that its temperature is high 
enough. Infants need to be kept warm, and only the face should be 
exposed, as is needful for the purpose of respiration. 

Should it appear to be feeble from any cause, and not seem warm 
to the hand, a bottle of hot water should be placed near it in bed. 
Warmth is essential to its life, and should it fail to generate sufficient 
animal heat the deficiency must be made up artificially. This is of 
especial importance in children born prematurely. 

It may be necessary to moisten the cotton enclosing the decaying 
cord with mild carbolic acid solution to prevent odor before the sepa- 
ration occurs. The cord separates in from five to seven days, leaving 
a partially healed ^tump, which may be dressed with carbolized 
vaseline or a powder of boric acid or aristol. 

The band should not be pinned too tightly about the child's body 
just snug enough to be comfortable, and in dressing an infant safety 
pins should always be used. 

All things considered, the best nourishment for a baby is that 
secreted by the mother's breasts. After labor and the mother and 
child have rested a few hours, it should be allowed the breast, which 
contains a secretion intended to act as a mild cathartic, and cleanses 
the child internally. Feeding a new-born child is generally needless 
and harmful. Perhaps a little pure water should be allowed to rinse 
out the mouth, but beyond this the supply provided by nature is 
sufficient. The infant should be allowed to nurse occasionally to 
encourage it, and to stimulate the milk glands of the mother, so that 
there may be a sufficient secretion. In from about forty to fifty 
hours, the full flow of milk is usually established, and by this time 
the infant gets thoroughly hungry and enjoys nursing. A newly 
born infant needs to nurse about every two hours throughout the day- 
time. It does not need to nurse so often during the night, two or 
three times being sufficient. 

It is much better for a child to lie down than to be rocked, and 
carrying it about the house is a bad and needless habit, which soon 
spoils the best baby. 



538 THE NEW MEDICAL WORLD. 

When, for any reason, the mother cannot nurse her child the sub- 
ject of artificial feeding must be considered. As the death rate 
among infants artificially fed is much greater than among those 
nursed by the mother, it should be regarded as a misfortune to be 
obliged to raise it upon a bottle. Artificial feeding, to be successful, 
requires a large amount of care. It is not by any means an impossi- 
bility to raise a healthy child without the breast. A very young 
infant should have rich, pure milk, one part ; mixed with pure water, 
three parts. A small amount of salt should be added and the whole 
sweetened with milk sugar and given warm. The addition of a little 
cream makes the resemblance to human milk closer. The added 
water, if not absolutely pure, should have been boiled and cooled 
before using;. 

Great care must be taken with the nursing bottle to have it 
scrupulously clean. When not in use it may stand filled with water, 
to which some baking soda has been added. When the mother 
nurses her infant she needs to be careful of her own diet, lest by 
carelessness the little one's stomach and bowels are disordered. 

Babies ought not to be dosed with paregoric, soothing syrups, 
or patent medicines, to produce sleep. A healthy child does not 
need to be lulled to sleep by narcotic drugs. Mothers are little 
aware of the harm they do when they drug their children to sleep, 
and of the liability of producing life- long injuries. Sleep ought to be 
natural, and the baby can do no more natural thing than to sleep. 
While soothing syrups produce sleep, it is not natural sleep. The 
nervous system is powerfully impressed, and the child jumps 
and starts while sleeping, or awakens startled and frightened. 
Xever, as you value the life of your infant, should you unnecessarily 
give it carminatives, soothing syrups, cordials or sleeping drops, 
When it frets and does not sleep see that tight bandages are 
loosened. A child ought to be put to bed regularly and taught to go 
to sleep without even being held or rocked. The clothing, espe- 
cially at night, should be light and loose, and afford free play for the 
limbs. A young child should be first undressed and sponged over 
with warm water, then put on a loose slip and see that the diapers 
are dry, soft and clean. It should sleep in a crib or cradle by itself, 
and if properly prepared for sleep, and it still frets, it is probably 
hungry. After a baby is three or four months old, barley gruel, 
made by boiling barley for a long time in water, is good to add to the 
milk if the bowels incline to be loose. When constipation is trouble- 



THE NEW MEDICAL WORLD. 539 

some thiii oatmeal gruel added to the milk will be admirable to cor- 
rect such a tendency. • 

Do not give a small child cake or candy to quiet it. Such things 
produce disordered stomach, loose bowels and other troubles. Tea 
and coffee are too stimulating, and hence unsuitable to be given to an 
infant. When it nurses from the breast it should be removed to its 
own place after it falls asleep. It is not considered a good plan for a 
mother to nurse a child when she is overheated or when greatly 
fatigued. As the salivary glands are inactive in young infants, a 
little pure water should be regularly given to allay thirst. 

When a baby is so constipated that oatmeal gruel does not relieve 
such a condition, a few drops of castor oil may be administered, or 
frequently an injection containing glycerine, or a glycerine supposi- 
tory may be used occasionally as needed. Castor oil is a valuable 
and safe physic. It should be given in small doses and repeated till 
action ensues. But when the diet of a baby is properly regulated 
physic will be needed very rarely, if at all. When vomiting occurs, 
unless from overfeeding, add a tablespoonful of lime water to each 
nurse till the stomach is again regulated. 

It should be remembered that hot weather diminishes the digestive 
ability of the stomach, when the food should receive increased atten- 
tion. In very hot weather diminish the amount of food, and avoid its 
being too hearty. When a child approaches teething, which begins 
about the seventh, eighth or ninth month, or sometimes sooner, 
a severe ordeal is often encountered, especially if the weather is hot 
and the stomach is weak and disordered. This is frequently a trying 
time for the baby, and results in disturbing either the nervous sys- 
tem, and the child, worries, frets, is irritable, and in some cases there 
may be convulsions, or the stomach is upset and the bowels are 
loose. A baby that nurses ought not to be weaned just before or 
during hot weather. When it drools, protect the chest by bibs, and 
if a tendency to bite is manifested, provide a rubber ring. The 
gums may be rubbed with the finger, and in some cases they may be 
bathed with a soothing lotion containing a small amount of cocaine. 
When they are very sensitive and appear to be painful, the following 
will afford relief : 

fy Cocaine muriate two grains 

Tinct. crocus fifteen drops 

Syr. tolu three drams 



540 THE NEW MEDICx\L WORLD. 

Mix and apply a little to the gums several times a day with the 
fingers. 

When the gums are red, inflamed and painful, the physician may 
decide to lance them, to relieve the nervous system and prevent 
convulsions. Should convulsions occur, place the child in a warm 
bath, apply cold to the head and give a mild laxative if necessary. 

The following prescription has relieved many cases of convulsions: 
Ijt Bromide of soda one dram 

Chloral hydrate one-fourth of a dram 

Syrup of tolu one ounce 

Anise water one ounce 

Mix and give one teaspoonful every hour till relief and rest are 
produced. This dose is suitable for a child from six to nine months 
old. For older children a larger dose can be used. In all these 
cases the benefits of pure air, especially the pure air of the country, 
should not be forgotten. A change of air has sometimes seemed to 
be the main factor in saving the life, where teething, debility, hot 
and impure air all combined to thwart the remedies employed. 

A little account of the process of teething will doubtless prove 
interesting. The teeth come in pairs. The two lower front teeth 
usually appear first, but sometimes the two upper ones precede them. 
These are the four incisors or cutting teeth, and in a majority of 
cases they appear between the seventh and ninth month. The next 
teeth to appear are called the lateral incisors, one on each side of the 
pairs already mentioned, so that by the time the child is one year 
old, there are eight front teeth, four upper and four under. Between 
the twelfth and sixteenth month four molars appear, two upper and 
two under. Between the fourteenth and twentieth month the four 
canines are cut through. These are also known as the eye or stom- 
ach teeth. Between the ages of one and a half and three years 
the second set of molars appear and this completes the set of milk 
or shedding teeth. The foregoing order is the usual one, but varia- 
tions frequently occur. The roots of the temporary teeth are 
absorbed by the approach of the permanent set underneath. The 
temporary teeth appear designed to last only until the permanent 
set is ready to appear. 

The permanent teeth are thirty-two in number, sixteen upper and 
sixteen under. They begin to appear usually between the sixth and 
seventh year, and the set is completed by the appearance of the 
wisdom teeth, which are tardy in arrival being delayed until some- 



THE NEW MEDICAL WORLD^ 541 

where about twenty years of age. At the time of the coming of the 
permanent teeth the mouth and gums have enlarged, and the tem- 
porary teeth loosen or fall out or should be extracted so that the 
permanent teeth may appear in their proper places. The temporary 
teeth ought not to be extracted too early, as their loss may cause 
contraction of the jaw so that the permanent teeth will be irregu- 
lar or crowded. The coming of the wisdom teeth often causes con- 
siderable inconvenience and in some cases suffering enabling one to 
sympathize with the tedious ordeal through which an infant passes 
in teething. The wisdom teeth, though last to appear, are often the 
first to decay and require removal. 

The care of the teeth is always important, and in their care clean- 
liness is the word to be emphasized, and even children should be 
taught the daily and proper use of a suitable toothbrush. The 
decay of the teeth is caused by particles of food between them which 
decompose and which ought to be removed after each meal. Even 
when the temporary teeth decay early, they should be preserved b}^ 
temporary filling. 

It is apparent to the medical man that a close relation exists be- 
tween sound health and sound teeth, for the latter are essential to 
the proper mastication and preparation of the food for digestion, a 
work which must be done in the mouth, and which will be poorly 
done if the teeth are decayed and sensitive. The permanent teeth 
are frequently attacked by tartar which is deposited around the 
gum. It sometimes extends below the gums, destroying the sockets 
of the teeth and causing them to loosen. This accumulation of tartar 
causes the teeth to be sensitive, affects the breath unfavorably and 
frequently the general health, as when it causes neuralgia and similar 
troubles. It is a fact that a great many young persons neglect their 
teeth. There is nothing which causes them to appear more unfavora- 
bly. A foul mouth is often the only acquaintance and introduction 
with the neglectful that a neat person would desire. The teeth should 
be brushed up and down twice a day, after breakfast and before 
retiring ; remaining particles of food should be removed by a 
toothpick or soft silk thread passed between them. The following is 
an excellent tooth powder, and may be used once a day in the 
interests of a clean mouth. 

I* Precipitated chalk one ounce 

Pulv. castile soap one ounce 

Pulv. orris root one ounce 



542 THE NEW MEDICAL WORLD. 

The above may be mixed and flavored with wintergreen, sassafras 
or rose to suit the taste of the person for whom it is prepared. 

The following antiseptic wash is harmless and can be used as 
required to cleanse the mouth, and it will also keep the gums in 
a healthy condition : 

3, Carbolic acid one dram 

Antisepsine one ounce 

Alcohol one ounce 

Glycerine half an ounce 

Oil of Wintergreen two drops 

Mix. Add a teaspoonful of this mixture to a wine glass full of 
water and use to rinse the mouth as needed. 

When the gums bleed easily, it indicates that the teeth need atten- 
tion and the tartar around them should be removed, after which the 
foregoing wash is appropriate. 

The teeth of some are much softer than those of others, and decay 
earlier, there being a deficiency in the organic matter which they 
contain. The teeth are unfavorably affected by sickness, by 
pregnancy and by the taking of unsuitable medicines. Medicines 
which affect the teeth should either be administered in pill form or 
else taken through a glass tube, and afterward the mouth should be 
rinsed with a solution of bicarbonate of soda, (common cooking 
soda.) 

Caries or decay of the teeth is a common affection, and causes 
severe pain after the cavity has extended so as to expose the sensi- 
tive nerve to the air. A little oil of clove placed in the cavity usually 
gives temporary relief from toothache. Other substances used for 
this purpose are laudanum, chloroform, ether and creosote. The 
last should be used with great caution as it may corrode the sur- 
rounding tissues and produce a sore mouth. 



IX.— CARE AND EDUCATION OF CHILDREN. 

In the care of children of all ages the regulation of their diet is a 
matter worthy of special attention. A liberal supply of well cooked 
food has much to do with the promotion of their well being, the 
bulk of which should consist of such simple articles as milk with the 
cereals, together with fruits. When meat is allowed, the quantity 



THE NEW MEDICAL AVORLD .">4o 

must not be too abundant, and the avoidance of too hearty suppers 
will prevent many attacks of sudden sickness and disturbance at 
night coupled with anxious solicitude. 

Those children who are physically frail, need to have still more 
attention paid to the important subject of their diet, so as to have 
in view an improvement of their bodily health and physical develop- 
ment. Xot only must their food be nutritious and wholesome, but 
it must contain sufficient variety to satisfy the demands of nature and 
tempt a sluggish appetite. 

Life in the city is not so favorable for the growth and moral devel- 
opment of young children as the country, but what is lacking may 
be supplied if appropriate attention is given to their welfare. Exercise 
and recreation need to be provided at all seasons of the year. This 
fact is receiving more adequate recognition than formerly, and is 
deserving of still more even than it is now receiving. 

Young children who are especially bright, smart and wise for 
their years need to be restrained or held back. Such children ought 
not to be sent to school before they are six or seven years old. The 
brain of the young child is often inclined to excessive activity, and 
fond mothers and other members of the family sometimes take delight 
in teaching a bright infant to say and do many things which tend to 
over- tax the mental capacity and over-stimulate the brain. Caution 
in this respect ought not to go unheeded. Small children ought to 
be kept free from excitement, especially of an emotional nature. 
Birthday parties, late hours or aping the ways of older people are all 
objectionable. 

Simple methods of instruction for young children are especially 
appropriate, such as used in the kindergarten schools, where attention 
is given to learning language, form, color, etc., in natural and 
attractive ways, and even this kind of training ought not to be too 
forcing in its character. 

The moral education of children should not be overlooked. The 
mother will be repaid for giving proper attention to this side of the 
child's nature. She must learn to interpret the wants, anticipate 
the fears and discover the defects of the children, so as to direct 
them aright. She must restrain and encourage, as the nature of 
each requires, and she will experience great pleasure and satisfac- 
tion in so doing. She must especially teach them truth, gentleness 
and affection, by precept and by example, at an early age. A 
mother possessing patience, gentleness and affection can assist in 



544 THE NEW MEDICAL WORLD. 

the development of these desirable qualities to a surprising degree. 
The restraints interposed by the mother should be firm but kind and 
calculated to improve the physical and moral well being of her chil- 
dren. Members of the same family vary in disposition and the 
training must vary so as to adapt itself to the requirements of each 
child. The best sj^stem of education at home or at school is that 
which draws out and develops the strength and vigor of each individ- 
ual mind. Dull scholars should not be despised and held up to ridi- 
cule before their schoolmates. Such scholars, in the long run, often 
outdistance those of greater promise, as they mature slowly. 

There is no good reason why boys and girls should not be educated 
together. Brothers and sisters are brought up together in the same 
homes, and there is no valid reason why they should not be educated 
together in the same schools or colleges. Where coeducation has 
been tried it has proved eminently satisfactory. The idea that the 
education of a girl or young woman can be more superficial or less 
thorough and extensive than that of her brother is not a good one, 
and ought not to prevail in the future. Prominent educators are 
recognizing these facts, and colleges are opening their doors with a 
more friendly welcome to the female student than formerly. 

Prizes for the brightest scholars are unjust. It is not the bright 
scholar, who can commit to memory easily, who needs encourage- 
ment, but the dull one. All who do well should share in whatever 
honors and prizes may be offered. 

The brain of the student cannot do good work without sufficient 
rest and nourishment. Over-feeding, lack of sleep, want of exercise, 
and too much or the wrong emotional excitement, are some of the 
things which interfere with the progress of education. No system 
of education should be allowed to seriously interfere with the 
health. All students need compulsory and systematic exercise. 

Instruction upon those delicate matters which may excite the 
curiosity of the young, ought not to be omitted or left to chance. 
Too much reserve and secrecy is possible, for this will increase 
rather than diminish the desire of the young for knowledge. Hence 
this should be imparted, carefully and truthfully. The teaching of 
elementary anatomy and physiology in the schools is important; 
the functions of the heart and stomach are explained, and in a 
suitable time and way, the other functions of the organs may be so 
explained as to satisfy the youthful mind without arousing its passions. 
It is easy and natural to pass from the study of plants to animal, 



THE NEW MEDICAL WORLD. 545 

and from the functions of one organ to that of another, and such 
information, wisely imparted, is far better than that learned from 
suspicious books or persons of doubtful morals. The mother should 
keep the confidence of her boys and girls so that she may impart to 
them such instruction with respect to themselves as will satisfy 
their desire for increasing knowledge, and be productive of sound 
health and good morals. 



CHAPTER XXXIII. 

NURSING. DIET FOR THE SICK AND HOW 

TO PREPARE IT. 



I. — Nursing. II. — Diet for the Sick and its Preparation. 

L—NURSING. 

THE success of medical treatment depends more upon proper 
nursing than is generally supposed. In the great majority of 
functional diseases nature would be able to perform the miracle 
of healing without medicine if only suitable attention were given to 
the diet. Many of the functional, and some of the organic diseases, 
result from faulty nutrition. The diet may be too scanty, too 
abundant, or inappropriate. In either case nature is misused and the 
process of recovery may be impeded. 

Much has already been said in the body of this work about diet and 
nutrition in connection with the treatment of various diseases and 
does not need to be repeated. A few practical matters, referring 
more directly to the nurse, male or female, remain for our considera- 
tion. 

Good nurses of either sex are often in demand for the care of the 
sick. They are more easy to find, and as a class, better qualified, 
than formerly. So much attention has been devoted to the im- 
portant subject of training nurses, by physicians and hospitals, that 
many have been induced and have found it profitable to fully equip 
themselves for professional nursing. A good nurse possesses such 
requisites as a cheerful disposition, good health, quiet manners and 
sound judgment. The need of a cheerful disposition in the sick 
room is obvious. Good nature is communicated from one to another. 
Like some diseases it is always contagious, but unlike them, its 
effects upon the patient are always favorable. 




c 
z 

n 



o 

w 



THE NEW MEDICAL WORLD. 547 

It is no easy task to do faithful nursing, for the customary rest is 
more or less disturbed. To satisfy the exacting demands of the sick, 
who are frequently difficult to manage and unwilling to be pleased, 
is often, a heavy tax upon the vitality of the nurse. A frail person, or 
one with impaired health, will not be able to endure such a trying 
ordeal. The people who employ a nurse are often unsympathetic 
and do not care to listen to complaints, for their minds being occu- 
pied with one invalid, they have no place for another, and hence a 
person in poor health should not attempt nursing. 

A quiet manner is especially a desirable quality in a nurse. It is 
difficult to think of a requisite which is so constant and important. 
Sick people ought not to be disturbed too frequently. Xoise, talking 
and commotion, are often very wearying to them. Fussiness, med- 
dling with the pillows, and raising the patient's head, may be carried 
to such an extent as to be a constant torment. The noise of a rock- 
ing chair is often sufficient to distract a patient beyond tellino-. If 
the pillow needs fixing or the head of the patient needs raising, the 
nurse should do it quietly, at a proper time and in a gentle manner. 
Some nurses indulge in talk about other patients in whom thev 
have been interested, how they looked, wmat they said, and how thev 
died. A nurse must not mention any such experiences, and if cases 
are mentioned by another should answer civilly any question asked 
without volunteering to give any details. 

A competent nurse does not need to attempt in any way to 
impress the fact of her qualifications upon a physician or others. 
Deeds, not words, form the standard by which one is correctlv 
estimated. There is no one thing which more fully recommends a 
nurse for her difficult work than a refined and quiet manner. 

A nurse requires good judgment because so many important matters 
demand attention. The sick room must be ventilated without en- 
dangering the patient. A nurse who " must have air " even though 
the patient catches a death cold from the direct drauo-ht of an 
open window is too inconsiderate or too obstinate to be desirable. 
A nurse should know how to regulate the temperature of a sick 
room and should be provided with a thermometer, an inexpensive 
article which will relieve of all anxiety in this respect. A nurse 
ought to be able to keep an accurate account of the patient's tem- 
perature, and hence it is necessary to be familiar with the use of a 
fever thermometer. A nurse ought to know how to give an enema 
properly, either rectal or vaginal, how to pass a catheter, how to 



548 



THE NEW MEDICAL WORLD. 



introduce a suppository, how to make a mustard or flaxseed 
poultice, flaxseed tea or cream of tartar lemonade, as well as 
the various methods of preparing suitable and palatable dishes for 
the sick. 

A good nurse will dress tidily, paying suitable attention to herself 
as well as the patient. The bedding needs to be frequently changed 
and in some diseases daily and to this she must give appropriate atten- 
tion. Sick people are fastidious, hence fragments of food should not 
be left around in sight of the patient, but are to be carried away as soon 
as possible. When food is brought, it should look inviting. No old 
messes, unattractive, dirty, or rumpled napkin should be used. A 
nurse ought to know thoroughly the following facts. In sickness 
food has to be adapted to the altered condition of the system. The 
careless administration of food may do much harm, especially in 
recovery from fevers. Loss of appetite and inability to digest food 
are symptoms in many acute diseases, but in recovery from fevers 
the appetite is usually strong, sometimes ravenous, and such conditions 
require the exercise of much good judgment. 

It was customary in fevers formerly to allow only a small amount 
•of food or drink but the present method, in which a free use of 
water, milk, malt and the various preparations of beef are allowed, 
yields better results. In fevers there is great waste of the bodily 
tissues and a generous supply of liquid food is indicated. In 
some cases small quantities of liquid food should be given like 
medicine hourly. Milk is the best food in fevers. It is a complete 
food in itself, containing all the nutritious principles, is cheap, easy 
to obtain and generally relished by the great majority of cases. 
When it disagrees or fails to be digested properly, it may be mixed 
with toast water, lime water or seltzer water occasionally where an 
aperient effect is desired or the alkaline mineral waters as Vichy. 
The use of the two latter waters with milk may be alternated with 
pleasant results. Whey, though not very nutritious, is pleasant and 
often useful, and when milk disagrees, it may be made for a time to 
take its place. Ordinarily food should not be forced upon the sick, 
and only as much should be allowed as can be utilized without causing 
distress or doing harm. In the use of food as with medicines it is 
not a large amount which is needed but the right kinds. 

During recovery from typhoid fever the diet needs to be still more 
generous, but it should consist of such simple articles as milk, rice 
well cooked, tapioca, custard, baked apples, fruit jellies, and some 



THE NEW MEDICAL WORLD. 549 

have advised raw meat chopped or pounded fine, or eggs added to 
soup and in this way they are easily digested and nutritious. 

A few fresh flowers may be allowed in the room, for they often 
brighten and cheer the patient. They can do no harm unless their 
odor is offensive and they otherwise annoy the patient which is 
unusual. 

II.— DIET FOR THE SICK AND ITS PREPARATION. 

Toast Water. — Toast a slice of stale bread till it is nicely browned, 
without burning it. Pour over it in a dish one pint of boiling water. 
It may be flavored with grated nutmeg. Let it cool, and strain. 
This makes a simple and pleasant drink. 

Rice Water. — Wash half a cupful of rice, put it on, in three pints 
of water, and boil for two hours. A little nutmeg, stick of cinna- 
mon, or a shred of orange or lemon peel, may be boiled with it to 
flavor. Strain, season, and use in diarrhoeal diseases. 

Barley Water.— ^Wash half a cup of pearl barley, put it on in 
three pints of cold water to boil for two or three hours. Then 
strain, season, and flavor with extract of lemon. 

Oatmeal Water. — Put a tablespoonful of coarse oatmeal in a 
pitcher containing a pint of water. Stir, and after a while strain 
and use to make lemonade or for a nourishing drink. 

Jelly Water. — Stir a teaspoonful of any acid jelly into a goblet 
of water and sweeten to taste. Currant, cranberry, plum, barberry, 
quince, strawberry, raspberry or blackberry jelly may be used in this 
way, all of which make pleasant drinks. 

Tamarind Water. — Into a glass of water stir a tablespoonful of 
preserved tamarinds. 

Lime Water. — Over apiece of unslacked lime, the size of a cubic 
inch, pour a pint of boiling water. Let it stand and settle, turn off 
this first water and add a quart of pure cold water. Stir together and 
let it settle again. Then pour this off and bottle for use as an 
antacid. Use a tablespoonful of lime water to half a pint of milk. 

Herb Drinks. — These are made by pouring boiling water over a 
small handful of the herb, as catnip, pennyroyal, camomile, etc. 
Strain after standing a few minutes, and sweeten to taste. 



550 THE NEW MEDICAL WORLD. 

Apple Water. — Boil a large juicy apple, which has been pared 
and cored, in a pint of water until the apple is cooked veiy soft. 
Strain and press out all the juice from the pulp. Sweeten and drink 
after it is cold. 

Gum Arabic Water. — Dissolve one ounce of gum and one table- 
spoonful of sugar in one quart of cold water. Flavor with lemon. 
This makes a pleasant demulcent drink good for irritation in the 
throat, or to allay a cough. 

Flaxseed Tea. — Take one ounce of flaxseed, one tablespoonful 
of white sugar, half an ounce of liquorice root and the juice of one 
lemon. Add one quart of boiling water, and after standing four or 
rive hours strain. 

Flaxseed Lemonade. — Cover two ounces of flaxseed with a 
pint of hot water and let it stand for two hours. Strain, add lemon 
juice and sweeten to taste. This is a good drink in fevers. 

Cream of Tartar Lemonade, — Put one teaspoonful of cream of 
tartar into a bowl and add one pint boiling water. Squeeze in 
the juice of a lemon and sweeten to taste. This is an excellent drink 
in all febrile conditions. 

Slippery Elm Tea. — Take one ounce of slippery elm bark and 
break into small pieces. Pour over it a pint of water and let it 
stand for several hours. This makes a useful demulcent drink. 

Sage Tea. — Take half an ounce of sage leaves, a tablespoonful of 
sugar and the peel of half a lemon cut up fine. Cover with a pint or 
more of boiling water. After standing half an hour strain. This 
may be used hot or cold. 

Arrow Root. — Mix a tablespoonful of arrow root with sufficient 
water to make a paste. Stir this into a pint of boiling water or 
milk. Orange peel may be used to flavor. It may be sweetened or 
seasoned to a taste. 

Slippery Elm Jelly — Take four ounces of slippery elm bark, 

pour over it a quart of cold water and let it stand over night. Add 

the juice and peel of one lemon, and let it simmer on the stove 
for fifteen minutes. Strain into a mould. 



THE NEW MEDICAL WORLD. 551 

Orange Jelly. — Take one ounce of gelatin, one pint of orange 
juice, and let them soak together half an hour. Add half a cup of 
sugar, one pint of boiling water, and stir until all are dissolved, then 
strain into a mould. 

Tapioca Jelly. — Soak two tablespoonfuls of tapioca in a teacupful 
of cold water for two or three hours. Then stir in a pint of boiling 
water. Keep it stirring and boil gently. Sweeten and pour into a 
mould. A little wine may be added if needed. 

Lemon Sauce. — Boil half a cup of sugar in two cups of water. 
Make a paste of a tablespoonful of cornstarch and cold water. Stir 
together and boil ten minutes. Add the juice of one lemon. 

Boiled Custard. — To one quart of boiling milk add two table- 
spoonfuls of cornstarch made into a paste with milk. Add three 
eggs well beaten, stir continually. Sweeten and flavor to taste and 
add a pinch of salt. The whites of the eggs may be beaten to a 
froth separately and put on the top of the custard. 

Tapioca Cream. — Soak three tablespoonfuls of tapioca in water 
over night. Pour off the water and add one quart of milk. Bring 
it to a boil and stir in the yolks of three eggs, one tablespoonful of 
sugar and a little salt. Flavor with lemon or vanilla. Frost with 
the whites of the eggs, beaten to a froth, and brown in the oven. 

Lemon Jelly. — Soak half a package of gelatin in half a pint of 
cold water for an hour, add a pint of boiling water, the juice of a 
lemon and two tablespoonfuls of sugar. Stir until the gelatin is 
dissolved and strain into a mould. 

Apple Souffle. — Bake half a dozen sour apples, scrape out the 
pulp, sweeten, add the whites of two eggs beaten to a froth, flavor 
to taste and bake a few minutes in an oven. 

Blanc Mange. — Take two tablespoonfuls of cornstarch and make 
a paste of it by adding a little cold milk. Stir this paste into a pint 
of milk, boiling it for three or four minutes. Pour into moulds or 
cups to cool. 

Iceland Moss Blanc Mange. — Wash an ounce of moss in cold 
water, then put it into a lace bag and put it on to boil in half a pint 



552 THE NEW MEDICAL WORLD. 

of water and the same amount of milk. Sweeten, flavor with vanilla 
and pour into moulds when it begins to thicken. 

Koumiss. — Take one quart of warm, fresh milk, add a tablespoonful 
of sugar and one- half of a compressed yeast cake dissolved in warm 
water or a tablespoonful of brewer's yeast. Let it stand till foamy. 
Put into stout bottles, use corks that have been soaked soft in boiling 
water, and tie them down with a stout string and put in a cool place 
or ice chest. Open the bottle by means of a champagne tap. 

Peptonized Milk. — See page 446. 

Thickened flilk. — Take one pint of hot milk, stir into it a paste 
made of one tablespoonful of flour, cornstarch or arrow root and a 
little cold water. Add a little salt, boil three or four minutes, stir- 
ring constantly. Flavor with extract of lemon, cinnamon or grated 
nutmeg. 

Whey. — Put a teaspoonf ul of liquid rennet or a teaspoonful of 
dry pepsin powder into a pint of warm milk. Let it stand till the 
curd evaporates and then strain. 

Wine Whey. — Take a wineglassful of sherry and add it to half a 
pint of boiling milk. After standing a while strain it to separate the 
whey. It may be flavored with grated nutmeg. 

Egg Nog, No. 1. — Beat up thoroughly a fresh egg, add sugar, 
then add a cup of milk, a tablespoonful of brandy and grated nutmeg. 
Whip well. 

Egg Nog, No. 2. — Brandy two ounces, cinnamon water two 
ounces. Rub up the yolks of two eggs with a tablespoonful of sugar, 
then add the brandy and cinnamon water. Stir in the whites of the 
eggs whipped to a froth. 

Egg Cordial. — Whip the white of an egg to a froth, add a tea- 
spoonful of sugar, one tablespoonful of cream and whip together, 
then add by degrees one tablespoonful of brandy and mix all thor- 
oughly. 

nilk and Egg. — Beat up a fresh egg and stir it into a half-pint 
of boiling milk, stir constantly and drink while hot. 



THE NEW MEDICAL WORLD. 553 

nilk Punch. — Mix a tumbler of milk and two tablespoonfuls of 
brandy, sweeten and flavor with grated nutmeg. 

Vegetable Soup. — Take two potatoes, one tomato and a slice of 
stale bread. Turn over them a quart of water and boil it down to a 
pint. Season with salt and flavor with celery. Strain it for use. 

Egg Broth. — Soak two ounces of pearl sago for half an hour in 
half a pint of water. Beat the yolks of four eggs in one-half cup of 
cream or milk, add one quart of beef tea and stir the whole together. 
A little wine may be added if required. 

Chicken Broth. — Clean a chicken, remove the skin, put into a 
quart or more of water, depending upon the size of the chicken. 
Add a tablespoonful of washed rice, a little salt and a sprig of 
parsley. Boil three hours. Skim off particles of fat. 

Beef Tea. — Cut up one pound of lean beef, put into a preserve 
jar with half a pint of cold water. After it has stood awhile put it 
into a kettle of hot water and simmer for three hours. Season 
the broth in the jar'to taste. Strain through a coarse cloth. 

Beef Tea. — Cut up a pound of lean beef, add a pint of cold water, 
set it on the back part of the stove and let it stand for an hour, then 
bring it forward and to a boil. Remove any fat from the top, season 
to taste and pour off. 

Beef Essence. — Place one pound of lean steak in a hot frying pan 
and turn after a minute. Let it simply heat through, then press the 
juice out of it with a lemon squeezer. 

Meat Juice. Concentrated. — Put one pound of lean beef cut up 
into pieces into a preserve jar, add a little salt, two tablespoonfuls of 
water and screw on the cover. Place the jar in a kettle of water, 
bring to a boil and boil for two hours. Press the juice out of the 
beef after it gets cold and skim off all particles of fat. This makes 
a concentrated food which may be used in small quantities. 

Meat Juice, Raw. — Cut up a pound of lean beef and add half a 
pint of cold water. Soak it all day occasionally shaking it. Press 
out the juice with a lemon squeezer and season. 

Mutton Broth — One pound of loin of mutton, water three pints. 
Boil till tender, add salt and a little pepper, and when cold skim off 
the fat. 



554 THK NEW MEDICAL WORLD. 

Beef Broth and Oatmeal Gruel. — Mix half a cup of oatmeal 
gruel and a pint of beef tea, heat to the boiling point and stir mean- 
time. Skim off any particles of fat. 

Oysters, Roasted. — Place one dozen fresh oysters in the shell in 
an oven till they open slightly. Remove the oysters and serve with 
pepper and salt. Oysters thus cooked are very digestible. 

Clam Broth. — Wash and boil a dozen clams, strain the broth 
over some crackers. 

Ice for the Sick Room. — Bind with a tape a piece of flannel to 
the top of a tumbler so that it will form a bag extending half way to 
the bottom, fill with pieces of ice, cover the top with a second piece 
of flannel. The ice will keep for a long time, because the melted 
water passes away from the ice to the bottom of the tumbler. 



AUTHOR. — See Frontispiece. 



M 



ANY readers of The New Medical World will doubtless 
like to know something about the author and his qualifications 
for the preparation of such a work and so the publishers have com- 
piled this brief sketch from " Stone's Biography of Eminent Physi- 
cians and Surgeons " and " The Biographical Review of Hampden 
County. " — born North Stonington, Ct., Sept. 29th, 1845, — father, a 
clergyman of strong character, possessing varied gifts, — mother, 
Almira Miner of Stonington, Ct., descended from old Colonial ancestry, 
— educated in the public schools of his native town, — prepared for 
college at Suffield, Ct., — graduated from Brown University 1870, — 
belongs to the famous class of which President Andrews is a member, 
— received the degree of A. M. from Brown in 1873, — studied medi- 
cine with Prof. Albert VanderVeer, — received the degree of M. D. at 
the completion of a course in the Albany Medical College, — one of the 
prominent physicians and surgeons of Springfield, Mass, — is a man of 
literary tastes, — qualified both by education and experience for the 
preparation of such a work, — the commendations received already 
from eminent sources confirm our views. The Dr. belongs to various 
medical and other societies, — ex-President of Hampden District 
Medical Soc, — fellow of American Academy of Political and Social 
Science, etc. 

The Publishers. 



A FEW REPRESENTATIVE MEDICAL 
CELEBRITIES. 



THE pictures of a few representative medical celebrities, American 
and foreign, are included in this work. No effort has been 
made to include more than a few of the many eminent men of the 
profession who are already recorded upon the roll of honor. It was 
intended to make the selection chiefly on the ground of original 
work in some particular line of medicine or surgery, but owing to 
popular interest in certain well-known men a few exceptions 
to the original plan have been made. It will be noticed that the 
outline given of the life work of each is much condensed and briefly 
recalls only a few biographical facts. 



556 THE NEW MEDICAL WORLD. 



William Harvey, M. D., — born in England in 1578, — died in 
1657, — everywhere honored as the discoverer of the circulation of 
the blood, — after receiving his medical degrees, he settled in London, 
— appointed lecturer at the College of Physicians, and in 1628 gave 
his views upon the circulation of the blood to the world after having 
taught them for nine years, — Avas physician to James I and also 
Charles I, — was the most eminent medical man of his age. 

Edward Jenifer, M. D., — born in England in 1749, — died in 
1823, — celebrated for the discovery of vaccination, — many honors 
were conferred upon him by foreign courts and the learned societies 
of Europe. Parliament in two grants voted him a total of 30,000 
pounds. His discovery has been of great service and is practiced 
successfully throughout the civilized world rendering his name im- 
mortal. 

Sir Astley Cooper, Bart. — born in England in 1768, — died in 
1841, — widely celebrated as a surgeon and occupied chairs as a 
lecturer upon both anatomy and surgery, — an enthusiast in his 
profession, — author of the first great work upon Hernia, also a 
celebrated work upon Fractures and Dislocations, — removed a tumor 
from the head of Geo. IV and received from him in return a baronetcy. 
His practice is said to have reached the enormous sum of 21,000 
pounds annually. 

Epiiraim McDowell, M. D., — born in Virginia in 1771, — died in 
1830, — studied medicine at Edinburgh, — settled at Danville, Ky, where 
in 1809 he performed the first ovariotomy, without anaesthetics, with a 
mob about his office threatening to lynch him if his patient, (a Mrs. 
Crawford,) did not survive the operation, — also a celebrated lithoto- 
mist, — operated successfully upon James K. Polk, who afterward 
became President of the II. S., — a pioneer in abdominal surgery w r ho 
earned the distinguished title, "Father of Ovariotomy." 





William Harvey, M. D. 



Edward Jenner, M. D. 





Sir Astley Cooper, Bart. 



Ephraim McDowell, M. D. 



558 THE NEW MEDICAL WORLD. 



Samuel D. Gross, M. D., LL.D., — born in Penn. in 1805, — 
died in 1884, — occupied chairs as professor of surgery in Louisville 
College, Ky., the University of New York, the Jefferson Medical 
College, Phila, — a noted surgeon, a skillful operator and a voluminous 
author, — made many original contributions to surgery, — was regarded 
in his day as the greatest living surgeon. 

Oliver Wendell Holmes, M. D., LL.D., — born in Mass. in 
1809, — died in 1894, — a skilled physician, celebrated anatomist, 
popular lecturer, voluminous author, — occupied chairs as professor 
in Dartmouth and Harvard Colleges, filling the latter for 39 years, — 
great fame due to a peculiar genius as a writer of both prose and 
poetry, — possessed a great diversity of talent, — works exhibit a wide 
range of thought, — was one of the founders of the Atlantic Monthly. 

Philip Ricord, M. D., — born in 1810 at Baltimore, Md, — died in 
1891, — a French physician and surgeon who won in Paris a world- 
wide reputation and had a very extensive and lucrative practice, — 
reputation due to his resources, his inventiveness and dexterity 
coupled with wide and accurate knowledge, — was consulting surgeon 
to Napoleon III, — wrote numerous medical works, — specialty venereal 
diseases. 

J. Marion Sims, M. D., — born in South Carolina in 1813, — died 
in 1883, — introduced the use of the silver- wire suture, — instrumental 
in establishing the women's hospital in N. Y. city, — received many 
honors abroad, — a member of learned societies in Europe and Ameri- 
ca, — author of a standard work on female surgery, — a monument 
has been erected to his memory by physicians. 





Samuel D. Gross, M. D., LL. D. Oliver Wendell Holmes, M. D., LL. D. 





Philip Ricord, M. D. 



J. Marion Sims, M. D. 



560 THE NEW MEDICAL WORLD 



N. S. Davis, M. D., LL.D., Chicago, 111., — born in State of New 
York in 1817, — has done pioneer work in the cause of higher medical 
education, — written much, — has filled many responsible positions, 
— has occupied chairs in the Rush Medical College and North- 
western University, the latter of which he was instrumental in 
organizing, — also dean of latter. 

D. Hayes Agnew, M. D., — born in Penn. in 1818, — died in 1892, 
— prof, of surgery in the University of Penn. — widely known for 
surgical inventions and work upon surgery, — called to Washington, 
D. C, to attend Pres. Garfield after he was shot. 

Fordyce Barker, M. D., — born in Maine in 1819, — died in 1891, 
occupied chairs as professor in Bowdoin, ~N. Y. Medical College and 
professor of clinical midwifery and diseases of women in Bellevue, 
— had extensive private practice, — wrote a treatise on puerperal dis- 
eases. 

Prof. Louis Pasteur, — born in France in 1822, — died in 1895, — 
celebrated chemist, biologist, scientific investigator, etc., — regarded as 
the foremost representative of the germ theory of disease, — paved 
the way for the antiseptic methods now so successfully used in sur- 
gery, — invented successful treatment for the prevention and cure of 
hydrophobia, etc., — turned his attention untiringly to searching out the 
causes of disease, — in 1874 was granted a pension by the French 
government of 20,000 francs. 





N. S. Davis, M. D., LL. D. 



D. Hayes Agnew, M. D. 





Fordyce Barker, M. D. 



Prof. Louis Pasteur. 



562 THE NEW MEDICAL WORLD. 



Sie Joseph Lister, Bart. — born in England in 1827, — has been 
connected with several universities at Edinburgh, Glasgow, etc., — as 
lecturer and professor upon surgery, — professor of surgery at Kings 
College Hospital, London, — surgeon- extraordinary to the Queen,-^ 
established antiseptic surgery or Listerism by the use of germicides, 
thus reducing the mortality in hospitals in a wonderful degree and 
annihilating the danger which had formerly attended operative sur- 
gery. He is the pioneer of apj)lied antiseptics. 

Prof. Theodor Billroth, — born in 1829 on the Island of Rugen, 
— professor of surgery at Vienna, — a master of surgical technique, — 
has given special attention to the healing of wounds, — -has had re- 
markable success in plastic operations, — is much admired for his 
courage, — has made himself famous by the performance of difficult 
and dangerous operations, — one of the most celebrated surgeons in 
the world. 

Sir Morrell Mackenzie, Bart. — born in England in 1837 and 
died in 1892, — in 1863, founded a hospital for the treatment of diseases 
of the throat, — summoned to attend the Crown Prince of Germany and 
obtained great notoriety for his disagreement with the German phy- 
sicians, — possessed of skill and great fertility of resources, — operated 
with dexterity and acquired distinguished success in his specialty. 

Robert Koch, M. I)., — born in Germany in 1847, — professor of 
hygiene at the University of Berlin, — famous for studies concerning 
the contagia of consumption and cholera, — discovered the tubercle 
bacillus, the germ which causes consumption, — has been awarded 
100,000 marks by the German government for this service. 





>ir Joseph Lister, Bart. 



Prof. Theodor Billroth. 





Sir Morrell Mackenzie. Bart. 



Robert Koch. M. D. 



INDEX. 



183 



Abdomen, 

bandage of, 

contents of, 

distention of, 

dropsy of, 349, 363 

enlargement of, 

in disease of spleen 

tapping of, 
Abdominal Cavity, 
Abnormal Products, 

in blood, . . 179, 180, 

in urine, 
Abortion (see miscarriage), 
Abscesses, 

of antrum, 

of alveola (gum boil) 

of brain, . 

•of kidney, 

of lachrymal sac, 

•of liver, 

■of lungs, . 

of rectum, 

In septicaemia, . 
Absorbent Vessels, 
Absorption, process of, 
Accidents (see Chap. VI.), 

bite of mad dog, 

bite of serpents, 

burns and scalds, 

dislocations, 

dog bite, . 

dio.vning, . 

fainting, 

foreign bodies in ear, 

foreign bodies in eye, 

fractures, . 

frost bite, . 

getting choked, 85, 306 

hemorrhage from ear, 

hemorrhage from wounds 

incised wounds, 

injuries of spine in falls, 

lightning stroke, 

poison gases, inhaled, 

poisoned wounds, 

poisons, 

scalp wounds, . 

sprains and bruises, . 

stings of insects, 



91 

85 
122 



312 



Page. 

161 

535 
161 

387 
401 
526 

35 2 
349 
368 

398 
184 

399 
530 
5°4 
300 
301 

253 
400 

280 

350 
322 

372 
184 

3 6 9 
369 
in 

5*5 
120 

113 
176 

123 
in 
112 
284 

273 
171 

119 

328 

H5 
124 
126 

159 

116 
100 
122 



469 



127 
116 
121 



Acetanilide, 

dose, 

in high temperature 

in la grippe, 

in rheumatism, . 
Acetabulum, The, 
Acids (poisons), 
Acid, Acetic, 
Acid, Carbolic (poison), 
Acid, Carbolic (antidote), 
Acid, Carbolic (dose), 

in abscess, 

in burns and scalds, 

in carbuncles, 

in chilblains, 

in eczema, 

in hay fever, 

in itching, . 

for lice, 

for leucorrhoea, 

in mouth wash, 

in nettle rash, . 

in scarlet fever, 

in shingles, 

in small pox, 

in vaginal wash, 

in vomiting, 
Acid, Carbolic Ointment 

for burns, chapped hands, 
cracked lips, cold sores, 
itching of skin, etc., . . 85 
Acid, Hydriodic Syrup, . . yy 

in asthma, . . . . 77 

in enlarged spleen, . . -353 

in hay fever, .... 296 
Acids, Mineral (poison), . . 91 

antidotes, . . . . -91 

aid digestion, . . . 330, 335 

in fevers, ..... 465 

in gastritis, ■.. . . . 335 ■ 

injure teeth, .... 491 
Acid, Sulphuric, Aromatic, . 382 

in cholera, .... 382 

in cholera morbus, . . . 381 
Acid, Oxalic (poison), . . ,92 
Acid, Prussic (poison), . . 93 

Acid, Salicylic (dose), . 77 

in corns, ..... 230 

ir> rheumatism, . . . 493 



Page. 

7i 

77 

478 

470 

77 

163 

88 

93 
92 
92 
77 
5°5 
JI 5 

5 11 
508 
219 
297 
216 
224 
438 
542 
221 

458 
217 

499 

478 

77> 337, 447 

85 



I N 1 > E X 



565 



Page. 
Acidity of gastric juice, . . 330 

of stomach remedy for. . -448 

of stomach in pregnancy, . 526 

of urine, .... 39S, 412 

of urine in pregnancy, . . 529 

Acne 212 

Aconite, as poison, . . .98 

dose of . . . -77 

as household remedy, . .Si 

how to give, . . . . 70 

in pleurisy, .... 322 

in acute diseases (early stages of), 65 
Acute Yellow Atrophy, 

of liver, 
Adam's Apple (see larynx), 
Addison's Disease, 
Age, affects pulse, .. 

affects respiration, . 

affects action of medicine 
Ages, doses for different, 

best for marriage, 

of first menstruation, 

of teething, 

of turn of life, . 

best for weaning the baby 
Agnew D. Hayes, M. D., 
Albumen, .... 398 

in Bright's disease, .' 

in scarlet fever, 
Alcohol, its use and abuse, 

antiseptic mouth wash, 

externally in baldness, 

externally in scarlet fever 

as stimulant, 
Alcoholism, Chronic, 
Alimentary Canal, . 
Alimentation (see food), 

children, diet of, 

rectal, .... 336 

sick, diet for, 
Alkalies (see antacids), 

in rheumatism, , . 
Alkalinity, of blood, . 

of urine, 

of pancreatic secretions, 
Alopecia (see baldness), 
Alteratives, 
Alum, dose of, 

emetic in croup, . 61, .82 

in filtering water, 

in glossitis, 

mouth wash, 

for excessive perspiration 
Alveolar Abscess 
Amenorrhcea, 

see menstruation, cessation of, 

symptom of pregnancy, 
Ammonia, as poison, 

dose of, . 

in bronchitis, . . . 317, 318 



57 



jo-' 
306 

405 

141 

142 

60, 76 

76 

433 
540 

434 
446 
560 

399 

401 

45 s 
102 

542 

458 

69 

104 

299 

3 1 

542 

376 

549 

. 9 r 

493 

J 79 

39^ 

191 

209 

7i 

77 

442 

3° 

5°5 
528 

206 

.01 



434 

525 

93 

77 



Ammon [a, in fainting, 

in headache, 
in hydrophobia, 

in hysteria, 

in pneumonia, . 

as stimulant, 
Amnesia, 

Amyloid Liver, . 
Anaemia, 

cause of headache, 

cause of heart murmur, 

tongue in, 
An. esthetics 

discoverer of use, 

in labor, 
Anatomy, . 

of bones, . 

of brain, . 

of bladder, 

of blood vessels, 

of cranial nerves, 

of ear, 

of eye, 

of face, 

of female organs, 

of gall bladder, 

of heart, 

of intestine, large, 

of intestine, small, 

of joints, . 

of kidneys, 

of liver, 

of lower extremities, 

of lungs, . 

of male organs, 

of mouth, . 

of muscles, 

of rectum, 

of skull, 

of spinal column. 

of spleen, . 

of stomach, 

of throat, . 

of trachea, 

of upper extremities. 
Anatomy, relation of to physiology 

to be taught to young how. 
Aneurism, 
Angina Pectoris, 
Animal Food, 
Anise, dose and use of, 

in colic of infants, 
Anodynes, 
Antacids (see alkalies), 

bicarbonate of soda, 

bicarbonate of potash, 

chalk mixture, . 

lime water, 
Anthelmintics, 
Anthrax. 



Page. 

1 12 

^47 
516 
482 

"> "> -~> 

82 

253 

35' 
•7i 

246 

361 

139 

72 
2 

534 
149 

'53 
2 33 

407 
366 

-35 
281 

-57 
J 55 
430 
344 
354 
370 
368 
166 
396 
34i 
l6 3 
3*3 
417 
298 
166 
37i 
153 
'57 
jo- 
328 
306 
312 
160 

1 5 r 

544 

3 6 3 

3 3 

3.5 

. 7^ 

3 8 9 

72 

. 59 
80 

415 
78 

79 

72 
;i2 



566 



INDEX. 



Page. 

Antidotes, to poisons, . . .90 
Antiferment (see pepsin), . . 330 
Antiperiodics (see quinine), . 84 
Antipyretics, . . . -71 
Antisepsine, ... 542 

Antiseptics, . . .16, 71 

solutions of, . . . 185, 125 
Antispasmodics, . . .68, 
Antitoxine (serum), 

how prepared, foot note, 
Antrum, The, 
Anus (see rectum), . . 370 

cancer of, 

deformity of, . 

fissure and ulcer of, . 

fistula and abscess of, 

injuries of, 

itching of, 

piles of, . 

stricture of, 
Aorta, The, . . . 355, 356 
Aperients (see cathartics), 
Aphasia, .... 

Aphonia, .... 
Aphrodisiacs, 

Aphthous, sore mouth (see canker 
Apoplexy, 

Appendicitis, . . 384 

Appendix Vermiform, 
Appetite, .... 

^ss of, 

prescription for, 

unnatural, 

worms, cause, . 
Apple Souffle, . 
Apple Water, 
Aqueous Humor, 
Arachnoid, The, 
Areola, The, 
Aristol, surgical powder, 

123, 126, 127, 



in catarrh, 
Arm, The, 
bones of . 

joints of, . . 160, 161. 

muscles of, 
Arnica, dose and use of 

in bruises, 
Arrow Root, in diet for sick, 
Arsenic, as poison, 
antidote, 
pigments of, 
as medicine, 
in acne, 
in cancer, 
in consumption, 
for corns, 
for headache, 
for psoriasis, 
(see Fowler's solution, 



483 

45° 

450 
300 

37i 
376 
37i 
372 
372 
37i 
373 
374 
375 
357 
61 

253 

309 

73 
302 

25 1 
385 
370 
140 

338 
339 
339 
339 

55i 
550 
2 59 
234 

525 

537 

295 
160 
162 
166 
168, 169 
. 78, 82 
119 

55° 
94 
94 
25 
74 
213 
518 

324 

231 

247 
222 



Arteries, 

aneurism of, 

degeneration of, 
Articulations, (see joints,) 
Ascending Colon, 
Ascites, (see dropsy,) 
Asphyxia, see drowning,) 

(see inhalation of gases,) 
Assafcetida, in hysteria, . 
Asthenia, (see weakness,) 

(see emaciation,) 
Asthma, 

prescriptions for, 

remedies and doses for, 
Astigmatism, 
Astringents, 
Atlas, The, . 
Atmosphere, 

(see air and ventilation,) 

polluted, . 

change of, in disease, 
Atomizer, spray, . 

in catarrh, 

in hay fever, 

in whooping cough, . 
Atrophy, acute yellow of liver, 

of muscles, (see wasting,) 

of consumption, 

from loss of appetite, 
Atropia, (see belladonna,) 

doses of, . 

with aconite and morphia 

in aphonia, 

in cholera, 

in cholera morbus, 

in corneal ulcer, 

in hay fever 

in night sweats, 

in peritonitis, 

in wetting bed, 

in whooping cough, 

to check secretion of milk, 
Attachments, muscular, 
Auditory Canal, . . 281 
Auricle, (see external ear, 

of heart, . 
Auscultation, 

(see ear over chest, . 
Author, (see frontispiece,) 

(see preface,) 
Axis, The, 

Baby, (see infants,) ' . 
anodynes, bad for, . 
born before doctor arrives 
tying cord, 
band for, . 
barley gruel for, 
bath for, . 
circulation of, . 



349 



142, 



Page. 
. 366 

• 366 

• 3 6 7 
. 166 

• 37o 

363 
in 

100 
482 
181 

445 
314 

• 3*5 
77, 79 

63, 264 
5S, 66 
. 158 
24, 29 
24, 26 
28, 29 
446 
296 
294 
297 
461 

352 
323 
323 
339 
81 

78 
82 

309 
382 

381 
274 
296 

325 
388 
412 
461 
82, 536 
167 
283 
281 

357 



159' 
282, 

356, 



3 T 9> 321 

-.555 
iii-iv 

. 158 

• 536 
72, 538 

• 53 6 

• 536 

• 537 

• 446 
537 
537 



201 



INI) E X 



567 







Page. 


Baby, clothing for, 




538 


cow's milk for, 




533 


excitement bad for, . 




543 


impure air, bad for, 




2Q 


mortality of, 


29, 


l 33 


need water, 




539 


nurse how often, 




537 


nurse how old, . 




446 


peptonized milk for, 




446 


soothing lotion for gums, 




539 


teething of, 




540 


warmth of, 




537 


weight and size of, . 




5 2 5 


Back, pain in, (lumbago,) 




243 


in pyelitis, 




400 


in Bright's disease, . 




401 


Bacteria, in air, 


. 21, 


I 3 I 


in blood, .... 




448 


in milk, .... 




465 


in water, . . 24, 32, 


3 s 2 ; 


474 


in disease, 


321, 


448 


cause all contagious diseases, 1 1 


. x 3 


Baldness, .... 




209 


prevention of, . 




211 


Bandage, after labor, 




535 


Barber's Itch, 




226 


Barker, Fordyce, M. D., 




560 


Barley Gruel, . '. 


446, 


538 


Barley Water, 




549 


BATH for infants, 


201, 


537 


Bathing, 


136, 


201 


Bed for labor, 




534 


Bed Sores, (see ulcers,) 




205 


treatment of same as burns and 




ulcers, . 




JI 5 


Beef Essence, 




553 


Beef Tea, 




553 


Bee Stings, (see stings of insects,) 


121 


Belladonna, tincture of, 




81 


causes redness of face, 




204 


externally for itching, 




218 


leaves in asthma, . 




3 r 5 


Belly Ache, (see stomach ache,) 


337 


Belly Band, . 


. . 


537 


Bethesda Water, 




64 


Beyeraoe, Water as, 


2< 


h 5° 


Biceps Muscle, 




16S 


Bicycle Riding, . 




46 


Bifurcation of Trachea, . 


312, 


1 T -> 

J l 3 


Bile, 




343 


in blood, . 






346 


in bowels, . 






346 


in urine, 




I48, 


398 


Bilious Colic, 






349 


Bilious Fever, 






464 


Biliousness, 






344 


remedies for, 




345' 


346 


Billroth, Theodor, Prof.. 




562 


Biologist, 




560 


Bismuth, dose and 


uses, 




78 



Bismuth, in cholera infantum, 

in gastric ulcer, 

in intestinal catarrh, 

in pregnancy, . 
Bites of Animals, 

rabid animals, 

dogs, 

insects, 

scorpions, 

serpents, . 

spiders, 
Blackberry Root, 
Black Eye, (ecchymosis 

remedy for, 
Black Vomit, 
Bladder, Gall, 

calculi in, . 

urinary, 

obscure affections of 

stone in, . 
Blanc Mange, 
Bleeding, (see hemorrhage), 

from bowels, 

from brain, 

from ear, . 

from lungs, 

from nose, 

from stomach, . 

from uterus, 

from wounds, . 
Blepharitis, . 
Blindness, 

from cataract, 

from corneal ulcers, 

from glaucoma, 

purulent ophthalmia 
Blisters, 

in jaundice, 
Blood, circulation of, 

diseases of, 

in urine, 

poisoning, 

vomit of, . 
Bloody Flux, (in dysen 
Blood Tonics, 
Blood Vessels, 

diseases of, 

intemperance affects 

of skin, 
Blushing, 
Boiled custard, 

milk in dysentery, 

water in disease, 
Boils, 

remedy for 
Bone, composition of, 

crepitus in fracture of, 

syphilis causes ulceration 

pain in, 
Bones, their number, 



Page. 

447 
336 

334 
527 
1 22 

5'4 

■23 
1 2 1 
I ' 2 

120 
1 22 
66 
271 
271 
476 
344 



344 



413' 

M5' 
145' 



407 
416 
4M 
55' 
2 53 
473 

• 251 

• '45 
3 2 3- 325 
292, 293 

335- 338 
M6, 531, 535 
124, 126, 127 

270 

277 
278 

274 
276 
272 

3> 6 ° 
347 
357 
i79 
400 
186 

135 

378 

79 
366 

367 
106 
198 

204 

55 1 

379 

o, 31 

509 

5 IC 

149 

117 

4^4 
423 
l 33 



146, 148 
H5 



tery) 



366 



of, 



568 



INDEX 



Bones, their form, 

of face, 

of skull, . 

of spinal column, 

of pelvis, . 

of lower extremities. 

of upper extremities; 

of skeleton, 
Bottle Feeding, 
Bowels, obstruction of, 
Brain, The, . 

abscess of, 

deformity of, 

tobacco affects, 

tumors of, 
BRANDY, in cholera infantum 

iced, in gastritis, 
Breakbone Fever, (see 

ralgic fever), 
Breasts, 

care of, 

milk of, 
Breath, bad, 
BREECH, (see hernia), . 
Bright, Dr. Richard, 
Bright's Disease, 
Bromide, of arsenic, 

of potash, 

of soda, . . 482, 485 
Bronchitis, 
Bronchitis, Capillary 
Broth, beef and oatmeal, 

chicken, 

egg, - 

mutton, 
Bruises, 

may cause abscess, 
Bubo, 
Buchu, . 
Bunions, 
Burns and Scalds, 



5 2 5> 



116 



470 
535 

• 535 
5 2 6, 537 

28, 305 

• 385 
. 400 

. 400 

222 

248, 461 

487, 540 

■ 3*5 

• 3 l 7 

■ 554 

• 553 

• 553 
553 
118 

. 119 

• 427 

• 64 
231 

12, 113 

(Xecum, The, . . . 370, 384 

CACHKXIA, in cancer, . . . 138 

Caffeine, dose of, 78 

in dropsy, . . .64, 366 

in heart disease, . . . 363 

in Bright's disease, . . . 402 

Calculi of gall bladder, . . 344 

Calculus, salivary, . . . 303 

vesical, . . . . . 413 

Calomel, in vomiting, . . 337 

in worms, . . . 395 

Camphor, 78 

in chordee, .... 428 
in fainting, . . . .528 

in gastritis, . . . .335 
Camphor Liniment, . . 83 

Camphor Liniment Compound, 83 
in neuralgia, • . . . 244 



Page. 

• I5 1 

• J 55 

• i53 

. 158 

■ 163 

. 165 

. 162 

. iqo 

• 538 

• 383 

• 233 

• 253 

• 255 
. 109 

• 253 

• 446 

■ jj5 



Camphor, Spirits of, 
CANAL, alimentary, 
auditory, . 

Cancer, 

of breasts, . . . 434 

of kidneys, 

of liver, 

of pancreas, 

of penis, 

of rectum, 

of stomach, 

of testicle, 

of womb, . , 434 

Cancrum Oris, . 
Canker, 
Capillaries, 
Capillary Bronchitis, 
Capsules 

Carbolic Acid, poison. (See 
acid carbolic), 

strength of solution, 
Carbolized Ointment, 
Carbuncles, 

Carlsbad Mineral Water, 
Carminatives, . 
Care of breasts, . 

of eyes, 

during menstruation, 

of skin, 
Carpus, (see wrist), 
Castor Oil, 

in cholera infantum, 
Catalepsy, 
Cataract, . 
Catarrh of ear, chronic, 

nasal, chronic, 

Southern California in, 

summer, . ; 

Catarrhal Stomatitis 
Cathartics, 

Catheter, . . . 409, 
Causes of Disease, general 

special, .... 
Celebrities, Medical, 
Cellars, ventilation of, 
Cells, epithelial, . 
Cerebellum, The, 
Cerebo Spinal Meningitis, 
Cerumen, (see wax in ear), . 
Cerebrum, The, 
Chancre, 
Chancroid, . 
Change of Life, 
Cheeks, The, 

Cheerfulness, . . 49 

Chicken Broth 
Chicken Pox, 
Chilblains, 
Children, care and education of, 

easily affected by medicine, 



Page 
82 
299 

282 

138 
518 
400 
35 1 
193 
419 

376 

3o° 

421 

438 
302 
302 
366 
3*7 
73 



92 
217 

5" 
404 

72 

535 
268 

435 

200 

161, 162 

62, 78, S3 

447 
482 
277 
285 

293 

4i 

295 

301 

61, 63 

410, 415 

9 
11 

555 

22 

401 

235 
241 

^3 
234 
421 
421 
434 
299 
546 

553 
440 

508 

542 

60 



i.vi) i : x 



569 



Page. 



|I0 



T. 



83 



Children not to sleep with old 

people, . 

Chills and Fever, . 401, 464, 
Chloral Hydrate, (poison), 

in asthma, 

in bronchitis, 

in convulsions, 

in corea. . 

in croup, . 

habit, 

in diphtheria, 

in teething, 

in whooping cough, 
Chlorine Mixture, 
Chloroform, dose, 

in cholera, 

in convulsions, 

in cough mixture, 

in earache, 

in hernia, . 

in labor, . 

in neuralgia, 

in tapeworm, 
Chloroform Linemen 
Chlorosis, 
Choice of a Home, 
Choking, (see accidents), 
Cholera, Asiatic, / 
Cholera Infantum. 
Cholera Morbus, 
Chordee, 
Chorea, 
Choroid, The, 

inflammation of, 
Chronic Alcoholism, 
Chronic Sore Throat, 

Chyle 

Ciliary Muscle, 
Ciliary Process, 
Circulation, The, 
Cirrhosis of Liver, . 
Citrate of Potash, 
Clam Broth, 
Clap, (see gonorrhoea), 
Clark, Dr. Alonzo . 
Clavicle, The, . 

fracture of, 
Clayus, (see corns) 
Cleanliness, 

in gonorrhoea, 
Cleft Palate, (see hare lip), 
Clergyman's Sore Throat, 
(see chronic sore throat). 
Climacteric, 
Climate, .... 
Clothing 

of infants, 
Cocaine and Chloral Habit, 
Cocaine in burns. 

in cancer, .... 



187 



1 w 



190 

466 

97 

3 r 5 

3 r 7 
4^7 
4S5 
44-1 
107 

449 
540 
461 

449 
73 

3S3 
487 
86 
286 
386 
534 
244 

393 
118 

182 
17 
85 

381 

444 

379 
428 

484 
258 
276 
104 
308 
192 

2 59 
259 

357 
348 
415 
554 
425 
388 
160 

*75 
229 

J.22 

439 
3°4 
ioS 



40, 

5- 



434 

39 
536 
107 
11 ; 



COCAINE in dysentery. . 
in itching, 
in nausea and vomiting of preg 

nancy. . 
in teething, 

Cod Liver Oil Emulsion, 

in scrofula, 
COFFEE, bad for children, 
Cold, taking, 

in the head, 
Cold Sores, (see herpes), S5, 217, 
Cold Water, dressings, . 293, 

in fainting, 
Colic, . 

bilious, 

renal, 
Collar Bone, (see clavicle), 150 

fracture of, 
Colles Fracture, 
Colon, The, 
Coma, .... 
Comedo, (see acne), 
Common Abbreviations, 
Common Sense. Medical, 
Composition Tea, 
Conception, 
Confinement, (see labor), 
Congenital Defects, 

of brain, 

of ear, 

of genital organs, 

of mouth and hard palate 

of rectum. 

Congestion, (of brain), 

treatment of, 

of liver, 

of lungs, . 
Conjunctivitis, . 
Constipation, 
Consumption, 

cessation of monthly flow 
Consumptives climate for, 
Contagion, . 
Contagious Diseases, 
Convulsions, 

in Blight's disease 

in hydrophobia, . . 515 

in scarlet fever, 

in teething, 

in worms, . . 39 

COOKING, (see diet for sick), 
Cooper, Sir Astley, 
Copper, salts of poison, 
CORD, umbilical, . . 524, 534 

spinal, 
Cornea. 

inflammation of 

ulcers of 
Corneal Opacities, 
Corns, . 



Page. 



j-j 



240 



245 



M7> 
322, 
in, 



5 2 7 

539 

191 
}6 



290 
465 

2 A2 
113 

349 
309 
160 

■75 
161 

37i 
146 



8 

65 
524 
53' 
2 55 
2^5 
287 
418 

304 

37i 

25 1 
86 

345 
321 
271 

389 

3 2 5 

5-3 

42 

27 

11 

486 

402 

516 

45 s 
54C 

395 
549 
556 
95 
536 
23 s 
258 
273 
274 
274 
229 



570 



I X I) E X 



Page. 

Coronary Arteries, . . 356 

Corpuscles of Blood, . .179 

Corrosive Sublimate, . 7 1 

poison, ..... 95 
antiseptic tablets of, . . 125 

in diphtheria, . . . -45° 
in blood poisoning, . . . 185 
in freckles, . . . .228 

in lice, 224 

lotion of, 208 

Coryza, Acute, .... 290 

Cosmetics, 202 

Cough, .... 143, 325 

Cough Mixture, . . 86, 453 

Countenance, The, . . .137 

Coverings of Brain, . 233 

Cowper's Glands, 

Cow Pox, 

Cramps, 

Cranial Nerves, 

Crazy Bone, 

Cream of Tartar, 

Cream of Tartar Lemonade 

Creosote, poison, 
in consumption, 

Crookes Tube, . 

Cross Eye, . 

Croup, . • • 44 1 

Crusts, 

Cyanosis, 

Cystitis, acute and chronic, 



Page. 



5C0 
380 

2 35 
160 
221 

55o 
92 

3 2 4 

5 
279 

443 

205 

138 

408 



Damp Locations, unhealthy, 19, 28 
Dandruff, .... 207 

Davis, Dr. N. S., ... 560 
Dead Animals and Bodies, . 

danger from, . . . .122 

Dead, Kissing The, danger from, 1 36 

Deafness, 282 

congenital, .... 287 

Death, causes of, n, 23, 132, 133 

from consumption, . . . 325 

signs of, . . . 135, I4°> 148 

Decaying Vegetables, 

unhealthy, . . . . -27 
Delirium, .... 135, 146 
Delirium Tremens, (see chronic 

alcoholism), . . . .104 

Deltoid muscle, the, . . 168, 169 
Delusion of insanity, . . 250 

Delusions, strange, . . 53 

Dementia of insanity, . -251 

Dengue, (see neuralgic fever), . 47c 
Dentition, (see teething), . . 540 

Diabetes, 403 

Diaphragm, . . 328, 340, 341 

Diarrhcea, . . . .66, 444 

in cholera, . . . 380, 382 

mixture, . . . • .86 

in typhoid fever. . .472 



Diastole 




355 


Diet, (see food), . 




3 2 


in Bright's disease, . 




462 


in constipation, 




39o 


in diabetes, 




404 


regulation of, . 




62 


when nursing infant, 




538 


for the sick, 




549 


(see typhoid fever), . 


• 473 


,548 


Digestion, . 


• 3 2 9> 


369 


alcohol deranges, 




T °5 


emotions disturb, 




49 


heat impairs, 




444 


tonics aid, 




67 


Digitalis, 69, 64, 363 


; 366; 


402 


Diphtheria, 


• 348, 


461 


Directions for testing the eyes, . 


264 


Disease, functional and organic, . 


I 3 I 


Disease, General Causes of, 


9 


bathing in relation to, 




136 


germs of, 


u 


, 12 


kissing in relation to, 




J 35 


mastoid, . 




287 


special causes of, 




7, 11 


symptoms of, . 




137 


temperature in relation to 


> 


133 


the skin in relation to, 




146 


Diseases of the bladder, 




ao8 


of the blood, 




180 


of the blood vessels, 




366 


of the brain, 




240 


of female genital organs, 




43 6 


of the ear, 




282 


of the eye, 




270 


of the glands, . 




189 


of the heart, 




359 


of the kidneys, . 




398 


of the liver, 




344 


of the lungs and trachea, 




3 J 4 


of the male genital organs 


>5 


418 


of the mouth and tongue, 




301 


of the nose, 




289 


of the pancreas, 




192 


of the rectum, 




37 ' J 


of the skin, . , 




202 


of the stomach, 




33 * 


of the spleen, . 




35 2 


of the throat and larynx, 




306 


venereal, .... 




421 


Disinfection, 


46l, 


463 


of typhoid stools, 




474 


Dislocations, 


176, 


177 


DISORDERS, of menstruation 


, 


433 


Diuretics, .... 




63 


Dizziness, .... 




247 


Dog Bites, .... 


122, 


123 


DOSES, always adult, 




76 


rules for, .... 




75 


Dose Table, 




77 


Dover's Powder, 72, j8 


, 320, 


53i 



INDE X 



571 



Drainage, . 
Dress, (see clothing), 
Drink, most healthful, 
Dropsy, of brain, 

in Bright's disease, 

in heart disease, 
Drowning, . 
Druggists, danger from 

prescribing, . 
Drum of £ar, 
Duodenum, . . 36S 

Dura Mater, 
Dust, in the house, 
Dusting Powder. 
Dysentery. 
Dysmenorrhea, (see 

menstruation), 

Dyspepsia. . 
Dysphagia, 



Ear Ache, . 
Ear Anatomy of, 

defects of, 

diseases of, 

foreign bodies in, 

inflation of, 
Ear Symptoms. . 
Ear Wax. . 
Eating, (see food), 

time for, . 
ECCHYMOSIS, 
ECSTACY, 

Eczema. 

Education, of children 

Effects of tobacco, the 

Egg Broth. 

Egg Xog, 

Elbow. The. 

Electricity, 

Eliminatiyes, 

Emaciation, 

Embolism. . 

Embolus s 

Emetics. 

Kmmenagogues, 

Empyema, isee pus in 

cavity), 
Endocarditis, . 
Enlarged, blood vessel 

heart. 

liver, 

prostate. . 

spleen. 

veins in pregnancy 
Enteralgia, (see colic I 
Enteric Fever, (see ty 
Enuresis, (see wetting ' 
Epidemic. 
Epidemics, destruction 



28: 



plural 



JO 



285 



J20. 



34S. 



phoid), 
the bed). 



of, . 
3 Sl > 474- 



Pack. 

21 

36 

50 

240 

401 

I II 



429 

2S2 
I92 
o "> ^ 

o, 27 

207 

37S 

4jj 

33 l 
140 

2S5 
2S1 
2S7 
287 
2S4 
287 
147 
283 
jj 
49 
271 

483 

218 

542 
109 

553 
55 2 
166 

2 53 
58 
445 
2 54 
362 
61 

7^ 

505 
361 

348 
365 
35i 
4M 
553 
5 2 5 
388 

47i 

412 
468 



;>/ 



Epidermis, . 
Epiglottis, . . . .307 
Epilepsy, 

EpiSTAXlS,(see nasal hemorrhage) 

292 
Ergot, .... 

fluid extract, dose, . 

in hemorrhage of lungs. . 

in hemorrhage of womb, 
Errors of Refraction, . 
Erysipelas. 

Erythema, .... 
Escharotics, 

Ether, ... 2, 4S7 

Ethmoid Bone, The, 
Eustachian Tube, 
Exanthem, (see eruption) . 457 
Excesses, hurtful, 
Excoriations, 

Exercise, . 43. 141, 406 

Exertion, immoderate hurtful, 
Exhaustion. 
Expectorants. . 
Extension in Fractures, 
Extracts. Fluid, 
Extremities, bones of lower, 

J 50' 153 

bones of upper, 
Eyeball. 
Eyebrow. 
LYE. care of. 

diseases of, 

examination of, 

inner canthus of, 

interior of, 

normal, 

in old age. 

squint or cross eye, 

symptoms, 
Eyelash. 
Eyelids. 
EYESIGHT, directions for testing, 



Face, bones of, 

expressions of, 

muscles of, 

pimples of. 
Facial Paralysis, 
Fainting, 

in pregnancy, . 
Falling of the Bowel, 

(see prolapse of rectum). 
Falling Sickness, (see epilepsy) 
Fallopian Tubes, . 431 

Farcy, (see glanders), . 
Far Sight, (see hypermetropia), 
Fats, (see carbo-hydra 34 

Fatty Degeneration of heart 

of liver, .... 

Favus 



Page. 
196 

443 
479 

293 
60 



68 



79 

3 2 5 

335 
262 

490 

204 

71 

534 

154 

282 

49S 

50 
205 

543 

46 

46, 49 

70 

174 



*55 

162 

260 
260 
26S 
270 
262 
261 
259 
256 
261 
279 

147 

261 
260 
264 



:o 



*57 
157 

212 

2 54 
1 12 
528 

3. 5 

479 
5 2 3 
5*3 
262 

3 6 

365 

35' 

227 



572 



INDEX 



Feeble Children, 
Feet, suffer from neglect, 
Felon, . 
Female, genital organs, 

pelvis, 
Femur, The, . . 163 

fractures of, 
Fetid Breath, . 
Fevers, 

temperature in, 
Fever, Scarlet, 
Fever Sores, 

Fibrin, . . . 179 

Fibula, The, 
Finger, dislocation of, 
Fissure, of rectum, 
Fissures, in the skin, 
P^ISTULA, rectal, 

salivary, 
Fits, 

Flatulence, 
Flaxseed, tea, . . 409 

lemonade, 
Flesh, . 
Flexors, 

FLOODING, (see uterine hemorrhag 
Florid \, climate of, 
Flowers, in sick room, 
Foetus, . 

movement of, . 
Follicles, (see villi). 

of stomach (see glands), 
Fontanelle . -154 

Food, 

animal, 

in Bright's disease, 

for children, 

in constipation, 

in cholera infantum, 

in diabetes, 



for infants, . . 537 

after labor, 

in pregnancy, 

in rickets, 

for the sick, 
Foot, The, . 
Forearm, . . .160 

fracture of, 
Foreign Bodies, in ear, 

in eye, 

in nose, 
Foreskin, (see phimosi 
FOUL, breath, 

mouth, 

odors, 

odors, signals of danger, 
Fowler's Solution, dose, 

in chorea, 

in chronic diarrhoea, 

in eczema, 



538 



i6t 



28 



Page. 

537 
230 

505 
43° 
43° 
165 
175 
305 
464 

i34 

456 
217 
180 
165 
177 
372 
205 

372 

3°3 
486 

333 

55° 

55o 

34 

168 

)434 
42 

549 
524 
526 

369 
330 
489 

32 

33 
462 

542 

39o 
446 
404 
539 
535 
529 
488 

549 
165 
162 

175 

284 

733 
291 

418 

140 

54i 
291 

24 
219 

485 

377 
219 



Fowler's Solution, in nervous 

disorders, 

in psoriasis, 
Fractures, . 

symptoms of, . 

treatment of, 
France, for invalids, 
Freckles, 

French Heel, an abomination, 
Fright, bad for children, 
Frostbite, . 
Fruit, valuable in diet, 
Furuncles, (see boils), 



Page 

374 
222 
171 
172 

173 
42 
227 
230 
484, 486 
119 

530 
5°9 



Gall, (see bile), . . . 343, 

bladder, .... 342, 

stones, ..... 

Galvanism, (see electricity), 

GANGLIA, (see brain substance), . 

234, 
Ganglionic Masses, 
Gangrene, of lungs, 

of mouth, 
Garfield, death of, 
Gargles, 308, 310, 311, 449, 
Gases, poison, 

sewer, . . . 22, 

Gastralgia, 
Gastric Fever, . 

ulcer, 
Gastric Juice, . 
Gelsemium, . 
Genital Organs, female, 

male, 
German Measles, 

soap, 
Gin Drinkers' Liver, 
Glanders, . 

(see poisoned wounds,) 
Glands, The, (see liver, pan 
and spleen, . 

of groin 

of intestines 

of lips 

lymphatic, . . . 187, 188 

Meibomian of eyelids, 

parotid, .... 299, 

of skin, . . 195, 196, 205, 

sub-maxillary and sub-lingual, 

supra-renal, . . . 397, 
Glands, The, tonsilar, 

in diphtheria, .... 

in scrofula, 

sebaceous disorders of, , 207, 

sudorific disorders of, 
Glasses, use of, . . . 264, 
Glaucoma, . 
Gleet, .... 
Glossitis, 
Gymnastics, (see exercise) 



214, 



creas 
191, 
423, 



346 
344 
349 

277 

238 

239 

140 
302 
184 

45 6 

100 

100 

337 

334 

335 

33° 
70 

43° 

417 

453 
222 

348 

5'3 
122 

352 
427 
368 

3°4 

ir 
261 

454 
207 

299 
405 
310 
448 
189 
208 
209 
265 
276 
428 
304 
45 



IN I ) K X 



573 



Gluten Flour, . 
Glycogen, . 

Glycogenic, function of liver, 
Gonorrhoea, 

Gonorrheal, rheumatism, 

Gout. 

Graham Bread, 

Granular Lids, 

Gravel, 

Green Sickness, (see chlorosis). 

Gross, Samuel D., M. D., 

Growths, .... 279 

Gum Arabic, (see acacia), 

water, 
Gumboil, 
Gums, . ... 

lancing or cutting, 

lotion for, 

unhealthy, 



Hair, 

cleansing, directions 

dandruff, . 

lice in, 

loss of, ... 

restoratives containin 
poison, . 

remedies to prevent 1 
Hair Dyes, . 
Hallucination, 
Hand, bones of, 

muscles of, 

training of, 
Hare Lip, 

Harvey, William, M 
Haversian Canals, 
Hay Fever, . 
HEAD, (see brain), . 

(see cranial nerves), 

bones of, . 

cleanliness of, - 
Headache, . 
Hearing, acuteness of, 
Heart, action of, . 

degeneration of, 

clot of blood in, 

description of, 

dilitation of, 

enlargement of, 

inflammation of sac, 

murmur of, 

neuralgia of, 

nourishment of, 

overwork of, 

palpitation of, . 

sac of, 

valves of, 

valvular disease of, 

work of, 
Heartburn, 



for, 



lead 



oss of 



!5° 



D., 



141 



hair 



I S I 



153 

241 

357 



'.U.K. 
I69 
342 
342 

425 
428 

494 

390 

27 2 

399 
182 

553 
3°3 
447 

55° 
301 
300 

540 
539 

54i 

*55 

210 

210 
22 *i 
209 

210 
211 

99 
250 
161 
168 

43 
3°4 
556 
I5 1 
295 
233 
235 
155 
201 

245 
283 

358 

365 
362 

354 
361 

365 
360 

361 

363 
356 

359 
365 
359 
356 
361 

354 
333 



['age. 

I 2 

444 
30 



6, 



r -> -> 

5jj 
! 45 



549 



Heat, .... 

debilitates stomach, 

destroys disease germs, 

not favorable to development 
of race, . 

sweating relieves heat, 
Hebrides Islands, 
Heel, bone of, 
Hemiplegia, 
Hemispheres, of brain 
Hemorrhage, 

of bowels, 

of brain, 

of ear, 

in eye,. 

after labor, 

of lungs, 

in miscarriage, . 

of nose, 

of stomach, 

in typhoid fever, 

uterine, 

from wounds, . 
Hemorrhoids, (see piles; 
Henbane, doses and use, 

in pregnancy, 
Herb Drinks, 
Hernia, 
Herpes, of lips, 

of genitals, 

zoster, 
Hiccough, . 

in peritonitis, 
Hip, dislocation of, 

fracture of, 
HlVES, (see nettle rash), 
Hobnail, liver, 

Holmes, Dr. Oliver Wendell 
Homeopathic, treatment, 
Horseback Riding, 
Hot Water, general uses of 

for eyes, . 
HOUSE, choice of location, 

furnishings of, . 

drainage and sewerage of 

ventilation of, . 

water supply of, 
Humerus, The, . 

fracture of, 
Hydatid Disease, 

of kidneys, 
v of liver, 
Hydrocele, 
Hydrocephalus, 
Hydrophobia, 
Hygiene, (see sanitary subjects), 

17, 26, 29 
Hyoid Bone, . . . .157 
HYOSCYAMUS, (see henbane), . 79 
Hypodermic Use of Medicine, 59 



41 
196 

[64 

25-1 
235 
'45 

1 45 

251 

M5 

277 
535 
323 

53' 
292 

335 

473 

434 
124 

374 

79 

527 

65 

3*5 
217 

217 

2r6 

340 

387 

177 

r 75 
220 

348 

>55S 

9 

46 

86 

269 

19 

. 20 

21, 22 

24 to 29 

29 to 32 

160, 162 

172 

352 

40c 

352 
420 
240 

15, 5M 



'7 



574 



I X D E X 



Page. 

Hypodermic Use of Medicine, 



in asthma, 


• 3 X 4 


in peritonitis, 


• 3S8 


Hypekmetropia, far sight, . 262 


, 264 


Hypertrophy, (see enlargement 


) 


of heart, .... 


• 365 


of liver, .... 


• 348 


Hysteria, .... 


. 480 


ICE, in fever, .... 


• 499 


in gastritis, 


• 335 


polluted by sewerage, 


• 30 


in sick room, 


• 554 


Iceland, infant mortality of, 


29 


moss, blanc mange, . 


• 55 1 


Icterus, (see jaundice), 


346 


Ileo-c.ecal Valve, . 


3S4 


Ileum, The, . 


368 


Ilium, The, ... 


163 


Illusions of insanity, . 


250 


Impacted Wax, in ear, 


• 283 


Incised Wounds, 


126 


Incubation Stage of Disease 


s 15 


of measles, . ... 


45 1 


of mumps. 


454 


of scarlet fever, 


457 


of small pox, 


497 


of whooping cough, . 


460 


Indian Meal, healthy, (see corn 




bread), ..... 


39° 


Indigestion, . . .49 


33 1 


food in chronic, 


•j -» *j 
jj3 


of infants, 


444 


peptonized milk in, . 


446 


Infant Feeding, 446, 537, 538 


539 


Infants, management of, . 


536 


Inflammation, . 


502 


of bowels, .... 


3° .3 


of brain, . 


241 


of choroid, 


276 


of cornea, 


273 


of ear, .... 


284 


of eyelids, 


270 


of iris, .... 


275 


of lungs, .... 


320 


of optic nerve, . 


277 


of retina, 


277 


sympathetic, 


276 


of tear duct, 


279 


of tongue, 


3°4 


Inflation, of ear, 


287 


Influenza, (see la grippe), . 


468 


Infusions, .... 


73 


Ingrowing Nail, 


507 


Innominata, The, 


163 


Insanity, 


249 


Insect Bites, . . . . 


121 


Insomnia, 


248 


Instruments, . 


1, 2 


Intemperance, . . . 102, 


104 



Interior, of eye, . 
Intermittent Fever, 
Internal Canthus, 
Internal Ear, . 
Intestinal Catarrh 
Intestines, the large, 

the small, 

the coats of, 
Iodine, 

in boils, 

for bunions, 

for corns, . 

for enlarged glands, 

for felon, . 

in hay fever, 

in sore throat, . 

in sprains, 
Ipecac, dose and uses, 

emetic, 

in bronchitis, 

in croup, . 

in tits, 

in whooping cough, 
Iridectomy, 
Iris, 

Iritis, . 
Iron, dose and use, 

in acne, 

in erysipelas, 

in rickets, . 

in scrofula, 

tonic, 
Ischium, The, 
Itch, 
Itching, 

of anus, 

in ivy poisoning, 

troublesome, 
Ivy Poisoning, . 

Jaborandi, 

Jaeger's Test Type, 

Jaundice, 

Jawbone, The, . 

Jejunum, The, 

Jelly, lemon, orange, tapioca, 

slippery elm, 

water to prepare, 
Jenner, Edward, M. D., 

497 
Jenner, Sir William, 

Joints, The, 

Kidneys, The, . 
description of, . 
diseases of, 

to preserve the health of, 
secretions of, 
section of. 
situation of, (see plates). 



/ « 



79 



Page 

2 59 

465 

261 
282 
376 
370 
368 
37i 
9. 8 4 
510 
231 
230 

456 
506 
296 

3°9 

118 

, 84 

61 

3i8 

442 
487 
460 
270 

25^ 
27 5 

79 
213 
490 
489 
191 

68 

163 

224 

215 

373 
99 

43 6 
98 



265, 



;oo, 



130, 



65 
268 
346 

368 

5.51 
550 
549 

556 
474 
166 

14S 

396 

399 

405 

39S 
397 



I N D E X 



... .. 



Kidxe\s. The. 

stone in pelvis of. 
Kissing, danger of in disease. 

in syphilis. 
Knee CAP, (see patella) 

dislocation of. . 
Knee Joint. 
Koch. "Robert .M. D.. 
Koumiss, 

in consumption, 
in dyspepsia. 



164 

3-4 



3-0' 0- 



16 



16: 



::" 



Labor. 

management of, 

premature, 

stages of. . 
Labyrinth, of ear, 
Lachrymal Sac, 
Lacteals, 
Laryngismus. 
Laryngitis. . 
Larynx. 

spasm of, . 
Laudanum, dose and use, 
Laxatives, <sce cathartics), 

Lead, poison and antidote, 

in water. . 

in hair dyes. 
Leg. The. ' . 

fracture of. 

paralysis of. 
see paraplegia 1, 

(see hemiplegia 1. 
-re locomotor ataxia >. 
Lemonade, flaxseed, cream 

tartar. .... 
Lemon Sauce. 
Lentigo. | see freckles), 
Leprosy. 
Leucorrhcea. 
Leuk.emia. . 
Lick, . . . 
Light, for reading. 
Lightning Stroke. . 
Lime Water and Sweet Oil. 

S 
Lime Water. 
Lines for Astigmatism. 
Liniments. . 

camphor. . 

camphor and chloroform 

menthol. . 
Lister. Sir Joseph, . 
Litmus Paper, 
Liyer. The. . 

diseases of, 

lobules of, 
Lobelia, dose. 

antispasmodic. 

in asthma. 



Page. 

396 
40c 

*33 
423 

164 

166 

5^ 

- - ■> 

::- 
224 



53 1 

533 
33° 

- - -> 

r :- 
282 

2S0 
369 

443 
3°7 
306 

443 
79 
61 
96 

3° 

99 

169 

*73 

!59 

-54 
2;4 

-54 

550 



68, 






8c 



16. 
79' 



55 1 
227 



437 
1S3 
223 
269 
116 



ll 3 

549 
263 

S4 
^5 
53 
S4 

5% 
398 

34i 

344 

342 

79 

69 



Locomotor Ataxia. 

- of Appetitk, 
Lower Extremities 
Lumbago. 
Lungs. The. . 

diseases of. 
Lymph. . 
Lymphatic System. ' 

vessels and glands. 



3M- 



fHE. 



Organs. The. 



Mackenzie Sir. Morrell. 
Malar Bones. The. . 
Malaria, .321 

Malarial Feyer. 

regions, .... 

sorr-. 

typhoid fever. 
Male Genital 

affections of 

description of, . . 

Malignant Pustule. 

diseases. . . 449 451, 

ulcers. 
Malleolus. The. isee ankle . 
Mammary Glands, (see breasts 

cancer of. . 

care of. .... . 

Management, of infants. . 

of labor, . . . . . 

of skin, ..... 
Mandrake, isee podophvllin), 
Mange. The. . . ' . 
Mania, isee insanity), . 
Marriage, 

proper age for, 

after syphilis. . 

Massage'. . . . .253, 
Masseter Muscle. . 
Mastoid, disease. 
Masturbation, isee evil habits 1, 

(see phymosis . 

Matches, care of. ... 
Materia Medic a. isee medicines) 
Maternity. 
Matrix, suppuration of, 
McDowell. Ephraim. M 
Measles. 

German. . 
Measly, pork, isee larvae). 
Measures. Fluid. 
Meat. 

causes gout, 

raw, chopped or pounded, 

to abstain from, when. 

infected. . 
Meat, juice. 
Medical. Abbreviations, 

celebrities. 

common sense. 

progress, . 



I'age. 

• -54 
■ 

5 

• 243 

• 313 

4"3 
465 
464 
217 
464 

- 7 
;r - 
457 

205 

1 6a 

_ : -5 

: i : 
536 

33< 

2c : 

61 



5'9 
D 



34. 



7j> / 



5 r 9 
522 

425 

482 

167 
287 

418 

41S 

97 

37 

530 

506 

556 
45 l 
453 
392 

7 ': 

33- 

34 

549 
426 

326 

• 75 

3^3 
8 



576 



INDEX 



Page. 

Medical, signs, . . . .75 

study fascinating, ... 6 

Medicine, doses of, . 75, 76, 77 

household, . . . .80 

methods of giving, . . 58, 59 

size of dose, . . . 9, 57 

a popular science, ... 7 

Medicines. . . 57, 87 

classes of, ... 61, 73 

how introduced, . . 359, 60 

affect teeth, how given, . 191, 542 

patent, . . . . -55 

sometimes work mischief, 8, 470 

sore mouth from, . . . 542 

Medulla Oblongata, . . 235 

Meibomian, glands, . . .261 

Melancholia, ... 251 

Melancholy, .... 530 

Membrane, mucous, . . 299, 329 

(see mucous coat). 

Membranous, croup, . . .441 

Meningitis, . . . .241 

Menstruation, . . . 433 

care during, . . . -435 

cessation of, . . . . 434 

delayed, 433 

profuse, ..... 434 
Mercury, in syphilis, . . . 424 
Metatarsus, . . . .165 
Micro-organisms, . . 13, 524 
Microscope, . . 1, 13, 401 
Milium, . . . . .215 

MlLK, (see diet in treatment of), . 

Bright's disease, . . . 402 
consumption, .... 324 
crust, . . . .218 

diabetes, ..... 404 
fevers, . . . 473> 475' 548 
measles , mumps, etc., . 452, 455 
cows for infants, . . 538 

for food, . . . -34 
for koumiss, . . . . 552 

and egg, 552 

peptonized, .... 446 

Punch, 553 

thickened, . . . . 552 

infected in consumption, . . 326 

medicated by giving to mother, 425 

secretion of in pregnancy, . 526 

secretion excessive, . . -535 

Mineral Acids, (see acids), . 91 

Mineral Waters, . 404, 411, 414 

Minnesota, for consumptives, . 42 

Miscarriage, . 530 

Mitral Valve, .... 356 

Moist Feet and Hands, . 206 

Moles, . . . . ' . .228 

MORAL, education of children, . 543 

Morning Sickness, . , . 525 

Mosquito Bites, . . . 122 



Page 
MOTHER, to instruct children, . 545 
Mothers' Marks, (see birth 

marks), ..... 518 

Mouth, the description of, . 29S, 306 

. 28 
301 

• 54i 
. 299 

. 207 
545 



• 3 02 > 
alcohol 



cleansing of, 
diseases of, 
foul, .... 
glands of, . 
(see red gum), 
washes for, 
Mucous Coat, action of 

on, ...... 

of alimentary canal, 

catarrh of, .... 

of eye, .... 

of intestines, . . . 368, 

medicines in inflammation of . 

oesophagus, 

of mouth and nose, . 

rectum, 

stomach, . . . 299 

throat, 

urethra and vagina, 
Mumps, . . . ... 

orchitis from, .... 

(see secondary inflammation), . 
Muscles, . 149, 166, 

of eyeball, 

of face, 
MUSCULAR, action in fractures, 172, 175 



289, 

3 2 9< 
306, 

425, 



111 respiration, 

fiber, 
Mustard, plaster, 

liniment, . 

poultice, . 
Mutton, 

broth, 
Myopia, 



J44 



26: 



">5 

299 

376 

261 

371 

66 

j-° 
299 

37i 
33 2 
3°7 
437 
454 
420 

455 
169 

168 

J 57 



*5 2 > 

447 , 

34, 

264, 



39 
167 

470 

493 

59 

333 

553 
268 



N^vus, (see birth marks), . . 518 

NAIL, ingrowing, .... 507 

Nasal Bones, (see bones of face) 155 
catarrh acute, (see cold in head) 290 
catarrh chronic, . . . 293 

cavities description of, . . 289 
cavities lining of, 289 

cavities ulcers in, . . .291 

Nausea, . . . . 143. 33^ 
in appendicitis, . . . 385 

in cholera infantum, . .445 

in gastritis, .... 334 
in hernia, ..... 386 
in peritonitis, .... 387 
in pregnancy, ... . 525, 526 

Navel String, (see cord) . 534, 536 
dressing for, .... 537 
stump of, .... 527 

Near Sight, (see myopia) . 

262, 264, 268 

Nerves, The, . . . 238, 239 



IXDEX 



577 



35« 



Nerves, cerebro spinal, 

cranial, 

of motion and sensation, 

sympathetic, 

of skin, 

of touch, . 
Narcotics, . 
Nervous Diseases, . 
NETTLE Rash, (see urticaria), 
Neuralgia, . . . 144, 242 
Neuralgic Fever, 
Nipples, (see breasts), . 
Nitrate of Silver, . 
Nitrogen, in the air, . 
Nog, Egg, . 
Nose, The, . 

catarrh of, 

growths in, 

hemorrhage from, 
NOSTRILS, (see nasal cavities 
Numbness, . 
NURSES, qualifications of, 
Nursing, 

(see cholera infantum), 

rules for baby, . . 



Pa<;k. 

238 

237 
. 240 

• 238 
. 198 

198, 238 

• 58 



479 
220 
217 

• 470 

525> 535 

96, 506 

. 24 

• 552 
. 289 

• 295 
. 292 

293 
289 
254 
546 
546 
444 
537 



H5' 



Oatmeal, in constipation, . . 390 
gruel in constipation of infants, 539 



32, 



gruel with beef broth, 
Obesitv, (see food), 
Obstruction, of bowels, 
Occipital Bone, The, 
CEsophagus, The, 
Oil, almonds, sweet, 

bergamot, 

cajuput, 

castor, 

clove, 

mustard, 

sweet or olive, 
Ointments, . 

85, 115, 211, 214, 216, 219, 223, 227, etc 
Old Sight, . 
Olecranon, The, 
OLFACTORY, nerves and bulbs, . 

2 35> 

Onychia, 

ONYXIS, (see ingrowing nail), 
Opacities, corneal, 

of lens, ..... 
Ophthalmia, (see conjunctivitis), 

granular, ..... 

purulent, .... 429, 
Opiates, care in use, 

caution in use, . 
OPIUM, dose and use, (see morphia) 

anodyne, ..... 

in bilious colic, .... 

in cough and diarrhoea mixture, 

in other affections, 410,388,415 



554 
496 

383 

• 154 
• 328, 329 

. 2C8 

. 208 

• 337 
■ 78, 83 
. . 85 

244, 447, 493 
85. 9 2 ' 35° 



264 
160 

236 

506 
5°7 
274 
278 
271 
272 
272 
66 
72 

79 
72 

35° 
86 



Opium, as poison, . 

as sudorific, 
Optic Nerve, The, 

commissure, 

division of, 

foramen, . 

inflammation of, 
Orange Jelly, . 
Orbits, The, 
Orchitis, 
Os Calcis, . 
Ossicles, The, . 
Ossification, centers of, 
Otitis Media, 
OVARIAN, neuralgia, 
Ovaries, The, 

situation and size of, 
Ovulation, 
Ovum, The, . 
Oxalic Acid, poison, 
Oxygen, 
Oysters, in diabetes, 

roasted, 



16 



Pack. 

• 97 

• 65 

2 58, 226 

• 360 

. 258 

• 257 

• 277 

• 551 

• 257 
420, 427 

. 164 
. 282 

• 149 
. 285 
. 242 

430. 43 2 

• 523 

• 43i 

• 43 1 

• 92 
88, 130 

• 404 

• 554 



Pain, (see neuralgia), . . 143, 72 
agonizing, how relieved, . . 3 
in stomach and bowels, 337, 380, 388 
in eyeball, . . -275, 276 

in colic, . . . 388, 399, 349 
in other diseases, 445, 400, 420, 433 
471, 387,409, 413, 493,. 469, 495, etc. 



Palate, bones, 

cleft (see hare lip) 

hard and soft, . 
Palpitation, 
Pancreas, The, . 

diseases of, 
Pancreatin, 
Papillae, of skin, . 

of tongue, 
Paralysis, . 

of eyelids, . 

facial, 

following apoplexy, 

following diphtheria, 

of one side of body, 

spinal, 
Para Phimosis, . 
Paraplegia, 
Parasites, 

of beard, 

in scalp, 

of skin, 
Paregoric, 

caution about, 
Parietal Bones, 
Parotid Glands, The, 
Parotiditis, (see mumps), 
Pasteur, Prof. Louis, 
Patella, The, . 



39i 



J 55 



79' 



156 

3°4 
300 
360 
191 
192 
191 
199 
300 
146 
270 

2 54 

252 

45° 
254 

159 
418 

254 
394 
226 
227 
229 
38i 
538 
156 

• 299 

. 454 

16, 560 

. 164 



593 



>7> 



53 



578 



INDEX 



197 

205 
206 



3°7 
306 



Page. 

Pectoris, Angina, . . . 363 
Pediculosis, (see lice), . . 223 
Pelvis, The, . . . 161, 163 
Penis, The, . . . . ,417 

Pepsin, ...... 330 

Peptonized Milk, . . . 446 
Pericarditis, .... 360 

Pericardium, The, . . . 359 
Periosteum, The, . . .153 
Peritoneum, The, . . . 387 
Peritonitis, .... 387 

Permanganate ofPotash, . 30 

(use in water). 
Perspiration, (see sweating), 

absence of, 

excessive, 

Pertussis, (see whooping cough), 459 
Phalanges, The, . . 150, 161 
Pharyngitis, (see acute sore 

throat), .... 

Pharynx, The, . 
Phenacetine, 

71, 79, 185, 469, 470, 474 

Phimosis, 418 

Phosphorus, poison, . . .96 
Phthisis, (see consumption), . 322 
Physiology, . . 151, 152 

Pia Mater, The, . . . 234 
Pigment, of skin, . . .195 

of eye, . . . . • 258 

Piles, 374 

PlLLS, for bad tasting medicine, . jt, 

cathartic, . . . 63 

for constipation, .. . . 391 
Pimples, face, .... 212 
Pink Root, for worms, . . 395 
Placenta, The, . . 524, 533 

retained, . . . 531 

Plague, desolations of, . , 23 
Plaster, mustard, . . . 470 

of Paris splints, . . 174 

Pleura, The, . . . 313, 318 
Pleurisy, . . . . " . 318 
Pneumonia, . . .52, 320 

podophyllin, . . . .63 
Poison, gases, .... 100 

ivy, ...... 98 

Poisoned, wounds, . . .122 

(see hydrophobia), . . -514 

(see anthrax), . . . -512 
Poisoning, how to treat, . . 90 

chronic, . . . . -99 
Poisons, 88 

vegetable, . . . .98 

POKEROOT, for obesity, . . 497 

Polypi, of ear, . . . . 285 

of nose, ..... 292 

of rectum, .... 375 

Pons Varolii, The, . . . 235 
PORK, cause of tape worm, . 392 



Paoe 

232 

320 

478 

86 

493 

73 



Potatoes, in scurvy, 
Poultice, . . .59 

flaxseed and mustard, 

sweet oil in, 

warm with laudanum, 
Powders, 

PREGNANCY, caution in medicine 
during, . . . 

clothing during, 

diseases of, 

symptoms of, 

termination of, . 

termination of, (criminal), 
Pregnant, advice for, 

first time, 
Presbyopia, (see old sight), 
Prescribing, home, 
Prevention, of disease, 

of cholera infantum, 

of consumption, 

of small pox, 
Privies, (see water-closets), 
Prolapse of Rectum, 

(see displacement), . . 39 
Prostate Gland, The, 

enlarged, . 
Pruritus, (see prurigo), 

of genital organs, 

of anus or rectum, 
Psoriasis, 
Ptyalism, 

Puerperal Fever, . 
Pulmonary Artery, 
Pulsatilla, in orchitis, 
PULSE, what can be learned from, 

quick in acute diseases and 
fevers, . . . 322, 323, 

slow in apoplexy and diseases 
of brain, . . -141, 

Pupil, The, (see iris), . 

in brain disease, contracted, 241, 97 

in acute diseases, enlarged, 
Purgatives, (see cathartics), 
PUSTULE, malignant, 



60 

530 
526 

525 

53' 
53' 
529 
5^ 
264 

52 
1 ;o 

445 
325 

50c 

' 24 
375 

43i 

408 

414 

215 

436 

373 
221 

525 
477 
358 
427 
140 

472 

242 

258 



Pustules, 

Pyemia, 

Pyloric End, of stomach, 

Quickening, 
Quick Lime. 
Quinine, dose and uses, 

in acute disease, 

in pleurisy, 

in malaria, 

in quinsy, . 

in remittent fever, . 
QUINSY, (see tonsilitis), 

TfcABTES, (see hydrophobia), 
Rachitis, (see rickets), 



204 



68 



457 
61 
512 
498 
183 
329 



520 

93 

79' 84 

65 

32c 

467 

3ic 

465 

3 C 9 

514 

488 



in i) ]•: x 



579 



Page. 
. 140 
160, 161, 162 

33 6 > 376 

5.14 

60 

37C 
37i 
3°9 
239 
262 

264 
399 
523 
358 
in 



142 



3i3 



Radial Artery, 
Radius, The, 
RECTAL, alimentation, 

injections, 

medication, 
Rectum, The, 

diseases of, 
Reduced Iron, . 
Reflex Action, . 
Refraction, errors of, 
Remedies, household. 
Renal Colic, 
Reproduction, . 
Respiration, . 97 

artificial, . 

failure of, 

ribs rise and fall in, 
Respiratory Organs, 

muscle of, (see diaphragm), 
REST, after labor, . . . 537 

after miscarriage, 

during menstruation, 
Retention of Urine, 
Retina, 

rods and cones of, 
Re-vaccination, . 499 

Rheumatism, 

allied to gout, . 

gonorrhoeal, 
Rips, 
Rice, as food, 

water, 

water stools, 
Rickets, 

Ricord, Philip, M. D., 
RIDING, (see exercise), . 

bicycle and horseback, 
Rigidity, of womb in labor, 
Ringworm, . 

ROOM, suitable for confinement, 
Rose Cold, (see hay fever), 
Roseola, (see German measles 
Round Worms, . 
ROWING, (see exercise), . 
Rubeola, (see measles), 
RUPTURE, (see hernia), . 



Sacrum, The, 

Sage Tea, 

Saline, mineral waters, 

Salines, (see Epsom salts), 

Saliva, action on food, 

excessive flow of, 

from mercurials, 

in mumps, 

in pregnancy, 
Salivary, fistula, glands 
SALOL, use, . . 410, 379, 
SALT, (see chloride of sodium 

antidote to nitrate of silve 



97 
161 

3i3 
39 
53i 
53' 
435 
411 

259 
277 
500 
491 

494 
428 
161 
34 
549 
445 
488 

558 
43 
46 

534 
226 

533 
295 
453 
394 
46 

45 1 

385 



• 163 

65- 55° 

• 345 
62, 78 

36, 33o 
528, 139 

J 39 

• 455 

• 525 
299 
474 

34 
96 



5°> 



291. 



P 

Salt, for eyes, inflammation of, 

emetic, use of, . 
good in bath, 
in gastric juice, 
for hemorrhage, 
in nasal catarrh, 
is poison, . 
in vomiting, 
Saltish Taste, of blood, 

SALT RHEUM, (see eczema. 

Fowler's solution in, 
Salts, Epsom, (sulphate of mag- 
nesia), . . 62, yii 

antidote in lead poison, 

use in appendicitis, . 

in peritonitis, 
Salt Water, bathing in, 

SANTONINE, for worms, 

Sauce, lemon, 

SCAR, (see crusts), 

Scabies, (see itch), 
Scales, 



:o.\ 



Scalp, to clean, 
dandruff in, 
eczema of, 
in favus, 
lice in, 
ringworm of, 
tumors of, 
wounds of, 

Scapula, The, 

Scar, 

scarfskin, . 



5 C ' 
394. 

2oq, 



208, 
201, 
2 10, 



125, 
194' 



205, 
195' 



160, 

498. 
196, 



46; 



r, 



injury of, (see burns and scalds) 
SCARLATINA, (see scarlet fever 

convulsions in, . 

otitis media from, 

pulse rapid in, . 

skin paralyzed in, 

strawberry tongue in, 

temperature high in, 

vomiting symptom of, 
SCHOOL, children, food of, 

co-education in, 

age to begin to go to, 

football too vigorous for, 

kindergarten methods in, 

physical culture in, . 
Schoolrooms, ventilation of 

vO"T>e looked after, 
Sciatica, (see neuralgia), 
Sclerotic, The, 
Scrofula, 
Scrotum, The, . 
Scurvy, 

Sea Air, beneficial, 
Sea Sickness, (see nausea 
vomiting), 

remedies for, 

Sea Voyages, in consumption, 324, 



419 



and 



A(.K. 

269 

61 

•36 

330 

325 
294 

88 
337 
•79 
218 
219 

93 
96 

385 
3SS 

136 
395 
55' 
498 
224 

210 

2IO 
211 
218 

227 
22? 
226 
208 
127 
102 
500 
199 

113 

45" 
486 
286 
141 

204 

138 

'35 
137 
326 

544 

543 
46 

543 

45 

. 27 

190 

243 
258 
189 
420 

231 

50 

143 
336 
326 



580 



INDEX 



»95 

20S 



113, 180 
16,30 



160 



Sea Voyages, for hay fever, 

in overwork, 
Sebaceous, glands, 

(see seborrhea), 

tumors or wens, 
Sedatives, . 
Self Regulation, 
Seminal Fluid, . 
Senile Baldness, 
Septicemia, 
Serpents, bites of, 
Serum, . 
Sewerage, . 
Sewer Gas, . 
Shingles, (see herpes zoster), 
Shock, . . .114 

SHOES, bad fitting cause corns, 

cause bunions, . 
SHORT BREATH, (see respiration) 
Short Sight, (see myopia), 
Shoulder, . 

dislocation of, . 

in fracture of clavicle, 
SIGHT, loss of, (see blindness), 

dim in old age, . 

far, (see hypermetropia), . 

loss of from cataract, 

loss from corneal ulcer, . 

loss from glaucoma, 

loss from purulent ophthalmia 

loss from sympathetic disease 

near, (see myopia), 

old (see presbyopia), 
Sigmoid Flexure of Colon, 
Sims, J Marion, M. D., 
Size, of infant at birth, . 

of tumors vary, 
Skeleton, The Human, . 
Skiagraph, (see X-Rays), . 
Skin, The, .... 

bathing of, ... 

burns of, .... 

care of, . 

cosmetics for, 

description of, . 

diseases of, 

diseases to be cured, 

friction of, 

general observation about, 

management of, 

in scarlet fever, 

sebaceous glands of, 

sweat glands of, . . 

in syphilis, 
Skull, bones of, . 
Sleep, 

cure for fatigue, 

from anodynes bad, 

in chloral and opium poison, 

rocking infants to, bad, 



49 



199 



457 



423 
153 



Pack. 
296 

248 
196 
207 
5.8 
69, 70 
48 

5 2 4 
2C9 

l83 

120 

5'0 

21 

IOO 

2l6 

137 
23O 
231 
142 
262 
166 
177 

175 
277 
262 
262 
278 
274 
276 
272 
276 
262 
264 

371 

558 

525 
204 
I50 

5 
146 

i37 
114 
201 
202 
194 
212 
201 
50 
202 
200 

458 
207 
205 

425 
156 

49 

5o 
538 

^7 
538 



Page 
248 
248 

251 

249 
248 

550 
77 
497 
500 
290 
197 
268 
201 
222 
522 
80, 91, 93 



^35< 



14. 



Sleep, want of, causes exhaustion, 
want of, (see insomnia), . 

Sleeplessness, in insanity, 
remedies for, 
(see insomnia), 

Slippery Elm, tea and jelly 

Small Doses, 

Small Pox, . . . 
prevention of, 

Smell, sense of, 
in dog, 

Snellen's Test Type, 

SOAP, in cleansing the skin, 
German in skin diseases 

Social Evil, The, 

Soda, bicarb, antacid, 
bromide of, 

80, 246, 480, 482, 485, 487 

Soil, for house, . . . 19 

pure, . . . . .22 

polluted, ... • 23 

SORE Eyes (see care of eyes), . 268 
(see diseases of eyes), . .270 
throat, acute, .... 307 
throat, chronic, . . . 308 

throat, quinsy, .... 309 

SOUP, vegetable, . . . • 55^ 

SPASMS, (see convulsions), . . 486 
from epilepsy, .... 480 
from strychnia, . . .98 

from teething, .... 540 

Special Sense, nerves of, . . 236 

SPECIFIC, (seeantitoxtine), . 451 

quinine, . . .68 

Spectacles, (see glasses), 264, 265, 268 

Speech, absence of, . . . 282 
(see deafness). 

Spermatozoa, (see testicles), 419, 524 



Sphenoid Bone, 
Sphincter Muscles, 
Spider Bites, 
Spina Bifida, 
Spinal Cord, 

hardening of 

injury of, . 

paralysis from, 
Spinal Column, 
Spine, bones of the, 

dislocation of, 

injuries of, 
Spirits, of camphor, 
Spleen, The, 

diseases of, 
Splints, 
Spores, 



i59 



Spotted. Fever, (see meningitis), 241 



Sprains, 

SQUINT, (see cross eye), 

Starch, (see food), 

bad in obesity, . 



154 
37i 
122 

255 
239 

254 

159 
411 

158 
158 
159 
159 
82 

352 
• 353 
i73» *74 
14 



238, 



254 
157 



19 



1 i.O 

279 

34 

496 



1NDE X 



581 



161, 



I02 



Page. 

274 
330 
43* 
439 
162 
2 

535 
425 
69 
104 
121 

3 2 9 
33« 
33 l 



Staphyloma, 

STARCH, saliva changes, 36, 

STERILITY, leucorrhoea may cause, 

(see gonorrhoea), 
Sternum, The, 
Stethoscope, 
Stillborn, . 

frequent cause of, 
Stimulants, 

(see alcohol), 
Stings of Insects, 
Stomach, The, interior of, 
cancer of, 
functional disturbance of, 

(see dyspepsia). 

inflammation of, . . 334 

neuralgia of, . . . . 337 

ulcer of, , - 33 5 

Stone, in bladder, . . . 413 

in gall bladder, . . . 344 

in pelvis of kidney (see pyelitis), 400 

Strabismus, (see cross eye), .' "279 

Stramonium, in asthma, . . 315 

in shingles, . . . .218 

Strange delusions, . • 53 

Strangury, . . . . 148 

Stricture, of urethra* . 410, 428 

of oesophagus, .... 328 

of rectum, . . . 375 

Strychnia, dose and use, . . 80 

alk?.loid of nux vomica, . . 98 

t antidote to chloral poison, . 98 

antidote to snake poison, . .121 

in paralysis of bladder, . . 411 

nerve stimulant, . . 255, 277 

in paralysis of diphtheria, . 450 

Stupes, turpentine, . . . 478 

St. Vitus Dance, (see chorea,) . 484 

Stye, 270 

Styptic, 66 

SUBLINGUAL, and submaxillary . 

glands, . .' . . . 299 

Sulphonal, in sleeplessness, . 80 

Sunlight, best disinfectant, 29 

Sunstroke, cause of, . . . 12 

SUPPRESSION, of urine dangerous, 148 

Suppuration of appendix, . .384 

of felon, ..... 506 

of matrix, .... 506 

Suppositories, . . . .60 

for dysentery, .... 379 

for enlarged prostate, . -415 

for inflammation of bladder. . 410 

for piles, . . . . 371, 527 

Supra-renal Capsules, 397, 405 

Suture, sagittal, the, . "153 

Sutures of skull bones, . . 154 

Sweat Glands, sudoriferous 

glands, . . . . .196 

Sweating to break up cold, . 65 



Sweating, excessive, 

favorable, . 
Sweeping, how to get rid of 
Sweet Oil, . . .83 
Sycosis, (see barber's itch), 
Sympathetic Nerves, 
SYMPTOMS, how to interpret, 

of dislocations, . 

of fracture, 
Syphilis, acquired, 

cause of iritis, 

cause of miscarriage, 

cause of skin disease, 

hereditary, 

causes infant mortality, 

marriage after, . 

pollutes all life, 

tertiary can be prevented, 

(see venereal affections), 
Syrup, hive, 

ipecac, 
SYRUPS, defined, use of, 
Systole, of heart, 



dust, 

35c. 
238, 



Page. 
. 206 

147 
27 

536 

226 

239 
137 

176 
172 
422 

275 
531 

205 

424 
425 
425 

12 

423 
421 

84 
84 

73 
355 



Taking Cold, 
Tamarind and toast water, 
Tape Worm, 

sure cure for, 
Tapioca Cream and Jelly, 
Tarsus, The, . . 150, 1 ,4 
Tartar Emetic, . 

antidote, . 
TARTAR, to be removed from 

teeth, .... 

Taste, as symptom of disease 
Tea, use of, . 

not good for children, 

not good for complexion, . 
Tea Beef, .... 

sage and flaxseed, 

slippery elm, 
Tear Duct, 
Teeth, decay of, . 

in digestion, 

action of medicine on, . 139 

decayed unhealthy, 

filthy, pollute atmosphere, 

in typhoid fever, 
Teething, 

Temperance, favors longevity, 
Temperature, in disease, 

in pleurisy 

in pneumonia, 

in quinsy, 

in typhoid fever, etc., 

in health, 

of atmosphere, (see climate). 
Tenesmus, straining, 
Testicles, The, . 

diseases of, . . 420, 



307 
549 
392 
393 
55i 
165 

95 
95 

542 
140 

36 

36 
200 

553 
55o 
55o 
279 
542 

33o 
542 

139 
28 

139 

54o 
50 
J 33 
3 '9 
321 
310 

473 
34 
40 

413 
419 
421 



582 



I N I) E X . 



3°7 



Testicles, (see orchitis), 
Testing Eyesight, 
Test Letters, 
Test Type, . 
Tests, for albumen and 
urine, .... 
Thermometer, fever, . 
Thickened Milk, 
Thorax, 
Thread Worms, 
Throat, boundaries of, 

affections of, . 306, 
Thrombosis, 
Thymol, in acne, 
Tight Lacing, effects of 
Tinctures, . 

of aconite root, 

of arnica, - . 

of belladonna, . 

of cantharides, . 

of capsicum, 

of digitalis, 

of iodine, . 

of Jamaica ginger, 
Tinea, (see ringworm), 

how contracted, 
Toast Water, 
Tobacco, 

effects of using. 
Toe Nails, ingrowing, 
Tongue, 

beefsteak, 

diseases of, 

enlargement of, 

inflammation of, 

tongue tie, 

wounds of, 
Tonics, . 
TONSILITIS, (see quinsy) 

to prevent, 
Tonsils, 
Toothache, 
TOUCH, sense of, 
Toxic Stomatitis, 
Trachea, 
Tracheotomy, 
Travel, beneficial, 
Treatment, (see any disease 

of fractures, 
Troublesome Itching, 
True Croup, 
TRUSS, for congenital he 
Tubercle Bacillus, 
Tuberculin, 
Tuberculosis, 
Tully's Powder, 
Tumors, 

of brain , 

of breasts, 

of scalp, 



nia, 



30 8, 



Page. 
427 
. 264 
. 266, 267 
. 265, 268 
sugar in 

399 
547 
552 
161 

393 
306 

3 C 9 
362 

214 
39 

73 

81 

82 

81 

2 1 1 

212 

248 

84 

83 
226 

227 

549 

12 

1 10 

5C7 
299 

J 39 
301 

3°4 
3°4 
304 
3°4 
67 
3°9 

3" 
3c 6 

542 
199 

3°3 
312 
312 
. 87 



Page 



109 
138 



85 ? 
198, 



51 



325 



5»7i 



173 
436 
441 
386 
562 

324 

"722 

°8o 
516 

253 
5.8 
208 



Tumors, of scrotum, 
Turbinated Bones, . 
Turkish Bath, . 
Twins, . . . 
Twitching of the Lids, 
Tympanum, The, . 
Typhoid Fever, 



204, 



420 

156 

497 
43i 

27c 

282 
47i 



boiling water destroys germs of 

16, 30 
germs of from drinking water, 32 
germs from sewers, . . 23 

where prevalent, . . 24 

to prevent spread of, . . 474 

Typhus Fever, ... 474 



• 437 
of vermiform 



Ulcers, L t lceration, 

of bowels from burns, 

from dysentery, 

of cornea, . 

of eyelids, . 

malignant, 

of nasal cavities, 

of rectum, . 

of stomach, 

of uterus, . . . 

(see suppuration 
appendix), 

varicose, 
Ulna., The, , 
Umbilical Cord, size of, 
Unnatural Appetite, 
Upper Extremities, , 

and lower jaw, . 
Uremic Symptoms, 
Urates and Urea, 
Ureters, The, 
Urethra, 
Urethritis, (see gonorrhoea), 



*5 



. 160 

• i55 
. 401 

148, 358 



148 



Uric Acid, 
Urinary Organs, 

diseases of, . 

Urine, . . 147 

abnormal products of, 

analysis of, important, 

blood in, . . 146, 148, 399 

highly colored, in sickness, 
148, 346 

incontinence of, 

retention of, . 

secreted from blood, 

suppression of, . . 397, 148 

symptom of disease, . . 147 

tests for albumen and sugar in 
Uriniferous Tubules, 
Urticaria, (see nettle rash). 



Use of Glasses, 

Uterus, The, (see womb), 
cancer of, . 
contractions of, 
displacements of, 



261 

431 
434 

435 



302 
114 

379 
274 
270 
205 
291 
372 
335 
438 

384 

3<=7 
160 

524 

339 
162 
156 
402 

398 
407 
408 

425 

495 

407 
408 

147 
398 
398 
40c 

398 
412 
410 

397 
411 
148 

399 
401 
220 
264 

432 
437 
533 
438 



I \ I > E X 



583 



Paok. 
UTERI'S, during and after 
labor, .... 
hemorrhage of, 

labor pains due to, 
ligaments of, 
pus from, . 
in reproduction, 

weakness of from miscarriage, 531 
Uvi'LA, (see soft palate), . . 300 



532, 


533 


434- 


437 




525 


43i- 


432 




4v 


52.1. 


524 



Vaccination, (see prevention of 
small pox, 

how and when to do it, ' . 
VALERIAN, (in headache), 

Valves, of heart, . . 356, 357 

of veins, .... 

of lymphatic vessels, 
Valvular Disease, . 

rheumatism as cause of, . 
Varicella, (see chicken pox), 
Varicocele, 
Varicose, ulcer, . 

veins, .... 

Variola, (see small pox), 
Varioloid, 
Vegetable Foods, 

prevent scurvy, . 

poisons, .... 89 

soup, . . . 

Vein, portal, .... 
Veins, The, .... 366 

varicose, .... 
VENA Cava, inferior, superior, 

(see plate), .... 

Ventilation, 

of schoolrooms, 

of shops, mills, mines, 

Ventricles, of heart, . . 356 
Veratrum, . 
Vermicular Motion, 
Vermiform Appendix, 

(see appendicitis), - 
Vertebra, . . . .157 
Vertigo, 
Vesical Calculus, 

(see stone in bladder), 
Vesicles, . . 217, 204, 448, 
Vesicul^e Seminales, 
Vessels, Blood, The, 
Vichy Water, (see Carlsbad), 
Villi Intestinal, 
VINEGAR, antidote to ammonia, 
Virus, . 
VISION, description of, 

indistinct, 

loss of, 
Vitreous Humor, 
Vocal Cords, The, . . 306, 



500 

501 
246 

358 
366 
188 
36 1 

493 
419 
419 
3 6 7 
367 
497 
499 

33 
232 

98 

553 
369 
3^7 
367 
356 
70 
26 
190 
326 

357 
70 

369 
37o 

3«4 
158 

247 
4i3 

498 
4c 8 
366 
404 
369 
93 
5oi 
257 
264 

264 

259 
3C9 



Voice, The, loss of, 

Vomer, The, 

Vomiting, . . . 170. 

in acute diseases, 350, 380, 

medicines to cause, . 6 

in obstruction of bowels, . 

in peritonitis, 

in pregnancy, 

in poisoning, 

in rupture, 

in scarlet fever, 

as symptom, 



3c6, 

336, 
382, 
1. 84 



52 



Paui . 

309 
156 

337 
445 
- *5 
3*3 
478 
526 
90 
386 
457 
143 



Walking, (see exercise), 
Walking Typhoid, . 
Wall Paper, danger of, 
Warm Bath, of sweet oil, . 

refreshing, . 

Warmth, necessary for baby, 
Warts, .... 229, 

Waste and Repair, (see food). 
Water Supply, The, 
Waxy Liver, (see amyloid), 
Weakness, (see anaemia), 

from heat, . . . . 

uterine, . 
Weak Sight, or eyes, . . 264, 
Weaning, .... 446, 
Weeping Eye, 
Weight, of infant, 
Wells, in cities danger of, . 2c 

Wens, 

Whey, 

Whites, The, (see leucorrhoca), 

Whitlow, (see felon), . 

Whooping Cough, (see pertussis 

Wine Whey, 

Womb ; (see uterus), . -43' 

Worms, 

Worry, Mental, danger of, ic 

WOUNDS, treatment of, 

of eyelids, 

incised, .... 

poisoned, .... 

of scalp, .... 

of tongue, 
Wrist, bones of, . 

dislocation and fracture of, 



46 
473 

25 
536 

50 
537 
292 

32 

29 

35i 

180 

445 
531 
269 

539 
279 
525 
1, 30 
208 
552 
437 
505 
459 
552 
432 
39' 
, 4 S 
124 
271 
126 
122 
127 

3°4 
161 
161 



X-Rays, 



4> 5> 6 



Yeast, illustrates septic germs, 15 

germs, . . . • 14 

Yellow Fever, . , 11,15,476 

germs of, 477 

hemorrhage in, . , . 476 



Zinc Compounds, poison, 



95 



' 












